Is Pilates Good for Sciatica?
The term sciatica describes the symptoms of leg pain and possibly tingling, numbness or weakness that travels from the low back through the buttock and down the large sciatic nerve in the back of the leg. Sciatica occurs most frequently in people between 30 and 50 years of age. Often any particular event or injury does not cause sciatica, but rather it tends to develop as a result of general wear and tear on the structures of the lower spine.
Common causes of sciatica are Lumbar Herniated disc, Spinal Stenosis, Degenerative Disc Disease, Spondylolisthesis, Piriformis syndrome and Sacroiliac Joint Dysfunction.
Exercise is usually better for healing sciatic pain than bed rest. Sciatica exercises are also important for the healthof the spinal discs. Movement helps exchange nutrients and fluids within the discs to keep them healthy. Many sciatica exercises focus on strengthening the abdominal and back muscles in order to provide more support for the back, so do Pilates.
Many Pilates studios are marketing their services as a treatment for lower back pain and sciatica, but does Pilates really help? Yes, it really helps if you find a good Pilates instructor who has back pain rehabilitation experience and who is familiar with your diagnosis, diseases and symptoms. Why Pilates instructor knowledge is so important? Because all Pilates exercises do not fit all sciatica clients and some exercises might be even contraindicated.
Here are briefly some underlying exercises that spine specialists recommend for each diagnosis of sciatica . These exercises help to relieve pain and prevent further back problems:
- Spinal stenosis: Focus on flexion exercises (forward bending). Flexing the lower spine relives pain and nerve irritation for people with spinal stenosis. They often feel better bending forward than standing up straight. Still it’s important to strengthen back and abdominal muscles and teach posterior pelvic tilt which allows the client perform more activities and exercises with less pain.
- Degenerative Disc Disease: Focus on spinal stabilization exercises, back extension exercises including the McKenzie method. All Pilates exercises are focusing spinal stabilization, so Pilates for DDD is really beneficial. However, back is fragile for DDD clients, so full flexion and intermediate spine articulation exercises are in some cases contraindicated.
- Herniated disc. Focus on spinal extension with McKenzie method and Spinal Stabilization training. Pilates is good, but has to be pain-free range.
- Spondylolisthesis: Focus on flexion based exercises and spinal stabilization program. It’s important to teach how the lumbar spine remains stable in a flexed position.
- Piriformis syndrome: Focus on stretching piriformis muscle, hamstring muscles and hip extensor muscles. Maybe only stretching exercises is enough to help to decrease this painful symptom. Finding neural pelvic position, spinal stabilization training and hip range of motion are all important for people with piriformis syndrome.
- Sacroiliac Joint Dysfunction: Focus on restore range of motion in SI-joint, which can be limited if the joint is inflamed. So, spinal stabilization, pelvic and hip exercises are all good.
All the above diagnoses cause sciatica pain but as you see the recommended exercises are very different. Pilates in general is good but definitely there is no “one size fits all” exercise for sciatica pain clients. Sometimes Pilates instructors are too confidence to taking care of people who suffer back pain, caused by sciatica. Many Pilates programs don’t give enough information about back disorders and many instructors don’t have enough experience either. It’s very important for Pilates instructors to know the client’s history of sciatica pain before they plan any Pilates program for their client. However, carefully planned Pilates program with a good hands-on skilled instructor make the life of sciatica pain client easier by relieving pain, strengthening and stretching muscles and increasing spine and joints range of motion. “Motion is lotion” is true here.