How to Prevent Sciatica Flare-Ups, According to Physical Therapists

When you’re on the other side of a painful sciatica flare, the first thing on your mind is probably, How can I prevent this from happening again? It’s a fair question. The shooting pain that can accompany irritation of the sciatic nerve is hardly anyone’s idea of fun. 

“For some people, sciatica can be a one time thing, but others can be more prone to occasional flare-ups,” says Samantha Stewart, PT, DPT, a physical therapist at Hinge Health. The good news: There are steps you can take to help prevent these flares. And it usually starts with moving your body more. 

Read on to learn more about what causes sciatica flares and what you can do to help prevent them from coming back, especially with exercises from our Hinge Health physical therapists.

Symptoms of Sciatica

Sciatica refers to pain that traces the path of the sciatic nerve, which is made up of a bundle of nerve roots from your spine that join together to form a right and left sciatic nerve. On each side of your body, the sciatic nerve travels through your glute (buttocks), and then branches off down the back of your thigh, behind the knee, into the calf, and finally ending in your feet and toes. Along this pathway, the nerves help control movements and sensations of the leg.

With sciatica, you can experience mild to severe pain anywhere along its path where there are nerves that branch from the sciatic nerve. For some, it can be a sharp, burning pain that shoots or radiates down the leg on the affected side. You may also experience weakness, numbness, or a tingling “pins and needles” sensation. The discomfort tends to worsen when sitting, coughing, or sneezing. 

Sciatica may come and go, and generally, flares resolve within a few weeks. If your pain isn’t getting better or it’s worsening, it’s a good idea to see a healthcare provider, doctor, or physical therapist. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

What Causes Sciatica to Flare Up?

There’s not one easy answer to what causes a sciatica flare. Because it can occur anywhere along the nerve’s path, it can present in many different ways for many different reasons, says Dr. Stewart. Some common contributors to a sciatica flare-up include:

• Sitting in one position you’re not used to for a long time. The body isn’t designed to stay in one position for long, and if your nerve is already inflamed, it can flare up if you find yourself in a position you’re not used to, for example if you’re stuck in the car for a multi-hour trip to visit family when you’re used to sitting at a desk most days. It could also be that you slept in a new position (like on a friend’s sofa bed) that aggravated the nerve. 

• Pregnancy or weight gain. The natural path of your sciatic nerve can be impacted by added weight, whether that’s from pregnancy or simply putting on more pounds. 

• Stress. When we’re stressed, we tend to hold that tension in our bodies in ways that can impact the sciatic nerve. 

The bottom line: “Flare-ups are generally like the gas light coming on in a car,” says Dr. Stewart. “It doesn’t mean the car is about to break down, it just means that something needs to change for it to continue to run well.”  

Reducing the Risk of a Sciatica Flare-Up

You may be able to reduce the frequency and intensity of your sciatica symptoms by making a few simple lifestyle changes, such as: 

• Exercising regularly. “Movement is medicine when it comes to reducing the risk of a flare-up,” says Dr. Stewart. Movement helps prevent flares by building strength and relieving muscle tension that can irritate the sciatic nerve. 

• Being aware of your body position. If your body feels uncomfortable, change the position you’re in. Sounds simple, but many of us stay in uncomfortable positions for too long. “A lot of times people say you have to move every five or 10 minutes, but everyone is different,” says Dr. Stewart. She advises listening to your body and focusing on finding positions that feel good to you. And when that position starts to feel a little achy, change positions again.

• Checking your body mechanics. One great tip to sidestep sciatica flares is to squeeze your butt when lifting and bending. “Not only does that engage your entire hip, but you’ll also naturally end up tightening your abs and activate stabilizers in your back,” says Dr. Stewart. 

• Manage stress. Stress causes inflammation and makes your muscles tense up. And since sciatica is often triggered by inflammation and pressure from nearby tissues, any change in inflammation levels and muscle tension could lead to flare-ups. There’s no way to magically get rid of the stress in your life, but you can take an active role in reducing it. Meditation, deep breathing, yoga, and stretching are all powerful ways to help reduce stress and increase feelings of calm. 

These exercises are recommended by Hinge Health physical therapists to reduce sciatica symptoms by relieving nearby muscle tension and helping the nerve glide more easily along its path. If you have sciatica, you can work with a physical therapist to design a program tailored to your specific symptoms, but these exercises are a great place to start.

While the above exercises can certainly provide relief during a sciatica flare-up, they can also help prevent a sciatica flare from occurring in the first place. Doing these moves even once a week can help prevent a flare of your symptoms. If a flare-up does occur, you can increase how frequently you perform these exercises to see if that provides more sustained relief.

And don’t forget to continue with low-impact exercise like walking, swimming, and water aerobics. These activities keep muscles engaged while simultaneously protecting the sciatic nerve. ​​

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Think of a Sciatica Flare-Up as Your Body’s Way of Getting Your Attention

A flare is a way to attract attention, and a flare of your sciatica symptoms isn’t much different, says Dr. Stewart. “The most important thing to realize about a sciatica flare-up is that your body is communicating with you that something needs to change,” she says. Whether a big project at work has you sitting for longer hours or you’re lifting heavy boxes more as you gear up to move to a new apartment, how your body reacts to these changes can be very telling. You may need to take more standing breaks or simply move your body in a different way to ease any tension or irritation. “The biggest thing to remember is that a sciatica flare doesn’t mean something is wrong with your body — it just means your body is sending you a signal to make some changes,” says Dr. Stewart. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Sciatica & Leg Pain. (2023, May 21). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/12792-sciatica 

2. ​​Sciatica Treatment. (n.d.). Body Logic. Retrieved from https://bodylogic.physio/conditions/sciatica-treatment/