Is Stretching the Best Sciatica Treatment? Why It Can Actually Make It Worse
- Colin O'Banion, DPT
- Feb 12
- 5 min read
Sciatica is one of those diagnoses I’ve seen a lot over my 20 years of experience. I get asked about it all the time, even outside the clinic. (Often at kids' birthday parties and soccer games.) It’s really common, but it’s also one of those complex issues that requires a bit of detective work.
What I love about treating sciatica is getting to do just that — being the problem-solver, figuring out the root cause of what’s really going on.
What Is Sciatica and Why Is It So Common?
Sciatica involves the sciatic nerve, which is this super nerve pathway that comes out of the lower spine and goes all the way down the back of the leg. It’s typically related to a disc issue. The lumbar discs — the ones in your lower back — often break down, usually in the back part of the disc. When that happens, the disc can push on the nerve root, causing pain in the buttocks, down the leg, and even into the foot.
The Real Root Cause of Sciatica Pain
In the clinic, I usually use a model to help patients understand what’s going on. You've got your lumbar vertebrae, the disc in between, and the sciatic nerve root coming out from the spine. Over time, what usually happens is the back of the disc starts to break down — we get a bulge or even a herniation. That’s when the disc can press on the nerve root and cause that classic sciatica pain.
What has the biggest influence on fixing this is identifying and removing the postures and movements that keep irritating the nerve. More often than not, it’s flexion movements — where the spine bends forward — that cause this pressure on the disc and nerve root.
So good therapy always starts with a solid evaluation to figure out the unique patterns in each person’s situation. We look at what’s contributing to the problem.
Are you sitting in a slumped posture?
Are you doing exercises that stress the spine?
Are you running in a way that causes compression?
There’s a whole range of possibilities, and we’ve got to track those down and either remove them, modify them, or teach your body how to move differently to stop the irritation.
Why Generic Sciatica Stretches Can Backfire
People often ask me, “What are the best stretches for sciatica?” But here’s the thing — I can’t give you the best exercises or stretches until I’ve seen your individual case. What helps one person might actually make someone else worse.
A lot of people search YouTube or Google looking for quick relief. You’ll see things like:
hamstring stretches or pigeon pose, and while those might feel good temporarily, they can actually aggravate the problem. Why? Because they often put your spine into a flexed posture — the very position that can push the disc back into the nerve root.
It’s what I call “scratching the itch.” It feels like you're relieving tension, but you're actually irritating the nerve more. Like when you scratch a mosquito bite. You might feel some relief in the moment, but it can easily make the condition worse.
That’s why it’s so important to avoid blindly following generic stretches. First, we need to understand what’s causing your sciatica before jumping into any exercise plan.
What Actually Works for Sciatica Relief?
Instead of jumping into random stretches, I like to start people with movements that are generally safe and often effective — but still simple enough not to irritate things further.
If I’m talking to someone I can’t treat directly, like a family member or friend, I usually start them with lying on their belly.
That position moves the spine into extension, which can help shift pressure away from the nerve root. Since most disc breakdown happens in the back part of the disc, this is a good approach to start easing the irritation.
Start by lying flat on your stomach for at least three minutes, ideally three times a day. From there, we can build up. A middle-level version would be a prone prop on the elbows, and a more advanced version would be a press-up. I like to add some gentle rocking and deep belly breathing while in these positions — it helps relax the hips and encourages spinal extension.
Posture also matters a lot. Sitting is often a major culprit with sciatica, especially when people sit in a slumped posture. That posture just rolls the disc backward and presses right into the nerve root. So a key part of recovery is minimizing sitting or at least sitting upright with good posture. Better yet, stand when you can.
Another underrated but powerful strategy is fast walking — if your gait isn’t too affected by pain. Even short bouts of five or ten minutes can help, as long as your arms are swinging and your body is moving naturally. It’s simple, but it can be really beneficial.
The Role of Expert Physical Therapy in Long-Term Recovery
Once we’ve identified the movements or postures that are causing the problem, the next step is treatment — and that goes beyond just exercises.
Good clinical care can include hands-on therapy, advanced manual techniques, dry needling, shockwave, and other modalities that help reduce pain and accelerate healing. These are powerful tools, but they don’t always fix the root cause. That’s where exercise, movement retraining, and education come in.
We need to get to the bottom of why the irritation is happening in the first place. That takes time, skill, and a personalized approach. What I do in the clinic is work one-on-one with each person to figure out their unique patterns and create a plan that actually solves the issue — not just temporarily masks the symptoms.
That’s why I don’t believe in a one-size-fits-all approach to sciatica. It’s about treating the whole person and solving the right problem.
Ready to Find Relief From Your Sciatica for Good?
If you’ve been dealing with nagging sciatic pain — or trying stretch after stretch without real relief — it’s time to get to the root of the problem.
At Colin O’Banion Physical Therapy in Boulder, I work one-on-one with people who’ve tried the conventional routes and still haven’t found lasting relief. Whether your sciatica is new or has been lingering for years, we’ll take a holistic, personalized approach to figure out exactly what’s causing the irritation — and how to fix it for good.
Book an evaluation to take the first step toward real relief.
How to Connect with Me:
Colin O’Banion, Doctor of Physical Therapy
Colin is a licensed Physical Therapist and founder of Colin O’Banion Physical Therapy in Boulder, Colorado. With 20 years of experience, he specializes in solving complex and chronic pain cases through a root-cause, integrative approach. Colin combines advanced manual therapy, shockwave therapy, dry needling, and movement re-education to help clients return to the activities they love. His one-on-one practice is dedicated to clients seeking lasting solutions when traditional PT has fallen short.
Comments