Preventing and coping with sciatica

Sciatica causes pain that begins in the lower back and spreads through the buttock, leg, calf and, occasionally, the foot. It can be a disruptive and painful condition, but early intervention and lifestyle adjustments can significantly alleviate symptoms and improve quality of life.

Increase exercise

Exercise is an important way to prevent sciatica. If you already have symptoms, staying physically can actually help diminish your pain. Consider these types:

• aerobic exercise, such as walking, jogging, swimming, dancing, and other activities that increase your heart rate
• strength training, such as exercises using free weights or weight machines, or isometric exercises, which involve contracting muscles without obvious movement
• flexibility training, such as yoga, tai chi, Pilates, and similar activities that increase both flexibility and strength.

The "best" exercise is the one that you like to do and will continue to do long term. Always "start low and go slow" when beginning a new type of exercise.

Strengthen your core

It might not seem obvious that a stronger core could improve your spinal health. But your core is not just your abdominal muscles, even though they are key contributors to the stability of your spine. Muscles in the back, sides, pelvis, and buttocks also are part of your core. Strengthening all of these muscles helps to support your spine.

Many types of exercise, including yoga and Pilates, can strengthen the core muscles. For example, planks and bridges are movements that target the core. You can find more options, with instructions, in the Harvard Special Health Report Gentle Core Exercises.

Avoid sitting for long periods

Prolonged periods of sitting put pressure on the discs and ligaments in the low back. If you have a job that requires a lot of sitting, take frequent breaks, or try a standing desk. Less sitting is better.

Practice good posture

Although there's no evidence that poor posture can cause back pain, it can make existing pain worse. But you don't have to walk around the room with a book on your head to practice good posture. Follow these tips:

• Pay attention to your body's position when you're standing or sitting.
• To prevent slouching, pull your shoulders down and back. Imagine your shoulder blades touching.
• If you work at a computer, take frequent breaks. Position your monitor so you can see it without bending your head down or tilting it back.

Avoid smoking

Besides its general harmful effects on your health, smoking reduces how much oxygen your tissues are getting. Because the discs in the spine don't have a great oxygen supply to begin with, smoking can increase the risk of disc degeneration and damage that can lead to sciatica.

Get enough sleep

Like your brain, your spine also needs rest. While you're awake and vertical, it supports the weight of your body and absorbs the forces of everyday life. Aim for seven to nine hours of sleep a night. Tips for spine-healthy sleep include the following:

• If you need or want to purchase a new mattress, get one that feels comfortable to you and that keeps your spine aligned. Firmer isn't necessarily better. Finding a mattress with a money-back guarantee can give you time to test your purchase and ensure it's right for you.
• If you sleep on your back, a two-piece wedge cushion may relieve pain from sciatica. One-piece rests under your legs and the other under your back. An alternative to buying a special cushion: put two thick pillows behind your back to prop you into a slightly raised position. Then place one or two flatter pillows under your knees to raise your legs.
• If you sleep on your side, place a contoured pillow (or any plump pillow) between your knees. Use a thick pillow under your head; this helps to align your upper spine.
• Sleeping on your stomach is the least preferred position if you have sciatica. But if this is how you're most comfortable, use no pillow or only a flat pillow under your head. Place a plump pillow under your hips to align your spine.

The vast majority of people who have sciatica get better within a few weeks. If you have sciatica, chances are also good that with careful attention, treatment, and preventive steps, you'll be able to keep it from coming back.

To learn more about ways to ease your sciatica pain, purchase Finding Relief for Sciatica from Harvard Health Publishing.

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