This article will detail some specific exercises for sciatica, including Dynamic Lumbar Stabilization and the McKenzie Method. Many readers have written to us inquiring about these forms of exercise treatment, so it was time to give them the coverage they deserve as serious contenders in the physical therapy arena.
Exercise therapy is one form of conservative treatment for sciatica which can be accomplished by the patient themselves, making it ideal for people with limited healthcare coverage or access to medical services. While sciatica exercises are not normally a means of achieving a cure, they can often help to manage the pain and may even assist in making an accurate diagnosis in particular circumstances.
McKenzie exercises are one form of popular lower back pain assessment and rehabilitation. The McKenzie Method was developed in the 1960s by a New Zealand based physical therapist named Robin McKenzie. This system is commonly associated with spinal extension exercises, since these are featured in treatment for most patients.
Patients are first classified into categories depending on the nature of their pain. While this is a good idea in theory, it is obvious that most medical diagnostic practices of back and leg pain are typically misguided and misdiagnosis is an epidemic concern. In McKenzie, I see no exception. Remember, sciatica is an extremely case-specific syndrome which usually defies categorization.
McKenzie exercises are geared to help a patient overcome acute pain by centralizing pain and preventing sciatica symptoms in the future through muscular exercise and postural correction. This makes McKenzie par for the course in terms of most physical therapy modalities. While the ideology and methods of McKenzie might differ to some extent, compared to general physical therapy, I see no reason to believe that the results will be much different at all.
Dynamic lumbar stabilization is another approach to exercise therapy for back pain and sciatica. DLS, sometimes known simply as lumbar stabilization exercises, is a progressive form of exercise therapy used to build muscular strength and stability in the lower back region. This program typically begins gently and increases with difficulty as patients increase in physical ability. Besides specific lumbar exercise and stretches, there is also a focus on general flexibility training, cardiovascular activity and overall fitness.
One of the main components of dynamic stabilization is helping a patient to find and recognize a position known as the neutral spine. This technique is supposed to help them prevent painful occurrences in the future by being able to re-establish this most natural position, taking pressure off sensitized structures.
Once again, this sounds great in theory, but I have seen little evidence supporting the fact that a neutral spine position even exists, and if it does, that being able to recognize and maintain it will provide any benefit from the usual causes of sciatica, including spinal nerve root compression.
Exercises for sciatica are certainly good intentioned, but often miss the mark when it comes to chronic back and leg pain care. I am an outspoken advocate of exercise for health, but have found it to be less than successful for permanently managing or curing most types of sciatica. For patients who have found lasting relief using exercise therapy, count yourselves very lucky and atypical.
That being said, exercise is a great way to temporarily stave off the effects of ischemia and can also help to get physicophobic patients up and around. This is always the first step towards recovery, so for that, exercise is highly recommended. To learn more about either of these 2 specialized forms of physical therapy, or any form of exercise treatment, talk to a qualified physical therapist or sports medicine physician.