Exercises for sciatica: herniated or slipped disc | NHS

Exercises for sciatica: herniated or slipped disc | NHS


EXERCISES FOR SCIATICA HERNIATED OR SLIPPED DISC I’m Sammy Margo.
I’m a chartered physiotherapist. Today I’m going to talk to you
about exercises for a herniated or slipped disc. But first we need to understand a little
bit about the anatomy of the spine and where the disc is. So, this being the spine,
this is the skull. This is the pelvis. These are the vertebrae. The yellow things are nerves that are
in between each one of the vertebrae. These are the discs which are like washers in between
each one of the vertebrae. What happens with a herniated disc is the disc material comes out
a little bit. It puts pressure
on the surrounding area. It can be just locally or on the nerve.
If it’s on the nerve, it may well cause pain down the leg,
sciatica, into the buttock,
into the back of the thigh, or into the calf and even into the foot. The main aim is to take the pressure
off the nerve and help reduce the inflammation. We’re looking to give this area space
so that it can breathe. First I’m going to show you some
positions of comfort you can get into to help alleviate the pain
from a herniated disc. Come along onto your tummy, please. And if you can, lie on your tummy. If you do have this problem, you might
not get into this position so easily. Lie yourself down flat. Head down. In so doing,
we’re opening up the low back. That will allow things to settle down. This can help alleviate pain
in this area, in the buttock, in the hamstring,
in the calf and in the foot. The main aim is to take the pressure
off this area. Lying in this position for a while
can help settle down your symptoms. It’s quite tricky
to get into and out of, but it’s a position worth doing. Moving onto the next position, can you
come and lie on your side, please? Lying on your side can sometimes help
alleviate the discomfort. Again, you might not be able to move
into that position that easily. It’s quite often your problem side
is uppermost. Can you bend your knees
a little bit more? Both of them? We’re getting into a foetal position
which again gaps the area. I’m placing a pillow between your knees, particularly for those of you
with an hourglass figure. That can help settle things down and allow the spine to be
in a more comfortable position. Just lying facing that way. OK? If you’re lying on the floor, you might want to put something
under the side to flatten the area. Sometimes lying in this position can
help alleviate the pain. It’s for you to figure out whether this
is helping alleviate the pain. Come and roll onto your back, please. Lying on your back,
often putting a pillow… Lie yourself down flat.
..under your knees. What we often do if this position
is not quite giving you relief… It will give you relief
because it’s softening your low back. We often build up pillows a little bit
more, put more pillows under your knees. For some people, we even put a chair
on the bed or they lie on the floor. By being in this position, that will help alleviate your low back
and gap the area. Even lying on your back
with your legs on a chair can help take the pressure off the area. We’re going to move on to exercises now.
Just put your feet down. Again, the main aim is
just to be very gentle. Gentle exercises,
just to help prevent any muscle atrophy and keep things moving. If any of these give you pain
or discomfort, you must stop. The way to do it is
just some gentle pelvic tilting. So, if you feel my hand, squash my hand down while you’re
sucking your tummy muscles in. Again, you’re gapping the joint, holding
it there, starting to wake things up. You often do get some muscle atrophy.
The muscles switch themselves off. We want to keep working things. Relax. And again.
Squash down as hard as you can, but holding each one for five seconds. You can do those ten times.
Obviously, I won’t be there. If you want to have a go at putting
your hand under your back yourself… And just push down. Holding it, holding it, holding it. If you feel any pain or discomfort,
stop and let it go. That’s a very good one to get going.
You need to do ten of those. The next one is buttock squeezing. And squeezing your buttocks. Squeezing your buttocks
as hard as you can. And relax. None of this should give you
any pain or discomfort. You can do ten of those,
holding each one for five seconds. When you feel ready, it’s very important to return to work
or to activity as soon as possible, however moderate it is. So, think about swimming
or cycling or gentle walking. Just some rhythmical exercises
that won’t aggravate you, that will just get you going. The sooner you return,
the better you’ll be. It’s very important that you have
proper resolution of your herniated disc so you don’t get another recurrence. So, a return to activity
as soon as possible. Respect the pain.
Also, look at things like weight. Weight is a big thing that can actually
put a lot of strain on your discs. Your posture at work, be it in the car,
be it at your desk… Your posture in bed,
what position you’re lying in. Make sure that your spine
is well-supported. And exercises. We’re leading sedentary lifestyles.
You’ve got to keep strong. Make sure you’re taking breaks
during the day at work, going for walks,
keeping strong and keeping mobile. IF YOU EXPERIENCE ANY PAIN
OR DISCOMFORT WHILE DOING THESE EXERCISES PLEASE STOP
AND CONSULT YOUR GP. FOR MORE INFORMATION GO TO:
www.nhs.uk/sciatica