Dealing with chronic aches and pains can take a toll not only on your physical health but also on your overall outlook on life. As you age, you naturally experience a loss in muscle mass and strength, which can make it harder to maintain mobility and stability. When muscle loss is compounded by a sedentary lifestyle, it can lead to increased strain on joints and muscles, resulting in painful conditions like sciatica. This condition, which occurs when pressure is placed on the sciatic nerve, can cause significant discomfort and limit daily activities, making it important to address and manage proactively.
“Older adults with sciatica are more likely to have muscle loss and weakness, and even a modest amount of exercise can make a big difference in improving mobility, strength and function, resulting in a reduction of sciatic symptoms,” says Lindy Royer, a physical therapist in Denver.
Here experts explain what sciatica is and how to manage symptoms through gentle exercise and other techniques.
What is the sciatic nerve, and why does it cause pain?
The sciatic nerve is the largest nerve in the human body. It starts in the lower back and travels down through the back of the leg to the heel of the foot. Royer says people who suffer from sciatica (injury to or pressure on this nerve) experience pain, numbness, burning or tingling in the lower back, buttocks and legs.
Dr. Ashley Caldwell, a chiropractor at Empower Chiropractic and primary care physician in Orlando, Florida, explains that the sciatic nerve often runs through the piriformis muscle (a flat, pear-shaped muscle that runs from your lower spine through your buttocks to the top of your thigh) and chronic pressure or injury to this muscle can also cause sciatic nerve pain.
She adds that pain from this nerve is often affected by aging. “Once people start to get older, they stop moving as much. As their bodies and their muscles get weaker and looser, that allows the sciatic nerve, or the structures around the sciatic nerve, to have less stability.” Without the support of the stomach, hamstring and glute muscles, more strain and pressure are put on the lower back and sciatic nerve, which causes pain.
How to know you’re dealing with sciatica
To make things more complicated, pain in your lower back and thighs doesn’t necessarily signal sciatica. Caldwell notes that sedentary lifestyles and poor posture can result in muscle pain in these areas, mimicking symptoms of sciatica.
She explains that sciatic pain will often radiate from the buttocks and/or lower back down through the entire back of the leg, while pain that extends from the buttocks and lower back to the knee may be piriformis syndrome (the piriformis muscle) and not sciatica.
Pain in the hamstring area of the body is also often confused with sciatica. Although the source of pain may not be the same, Caldwell says similar exercises can help alleviate pain in those areas of the body, even if they are not caused by the sciatic nerve.
”I like to show people stretches for their hamstrings and their piriformis and all of the muscles that connect to their pelvis. Once these muscles are strengthened and elongated, it will reduce pressure on the lower back and help the body adapt to any movements [it’s] making on a regular basis, especially if [they are] repetitive.”
5 sciatica exercises for seniors
Royer and Caldwell agree that these exercises for sciatica pain for seniors can be performed at home to prevent and treat sciatica. ”Research is clear that exercise is an effective strategy for minimizing sciatic symptoms because it helps improve mobility, strength and function while reducing pain,” says Royer.
1. Pelvic tilts
- Lie on your back with your feet flat on the floor. Bend your knees with your legs about hip-width apart.
- Imagine your pelvis as a bowl, open to the ceiling.
- Coordinate this movement with your breathing.
- Gently tip the bowl (your pelvis) toward your face, and then toward your feet and finally, side to side.
- Repeat five to eight times in each direction.
You can do this exercise sitting on a chair, if you’re not able to lie on the floor.
2. Knee to chest
- Lie on your back and gently draw one knee to your chest with your hand on the shin, or around the back of your thigh.
- Inhale and exhale as you hold for 20 to 30 seconds.
- Gently release your leg.
- Repeat five times on each leg.
To do this in a chair, perform the same movement as above, using your arms to support your leg.
3. Figure-four stretch (lying down)
- Lie on your back with your knees bent and feet flat on the floor.
- Cross one ankle over the opposite knee, forming the “figure four” shape.
- Reach your hands through the gap and gently pull the uncrossed leg toward you.
- Hold for 20 to 30 seconds and then switch sides.
Figure-four stretch (seated)
To perform this stretch in a chair, sit on a chair with your feet flat on the ground. Cross one ankle over the opposite knee, creating a “figure four” shape with your legs. Gently lean forward from your hips to deepen the stretch, keeping your back straight. Hold for 20 to 30 seconds, then switch sides.
4. Seated hamstring stretch
- Sit on the edge of a chair and straighten one leg out in front of you.
- Bring the top of the foot towards you — toes towards the shin — and hold for 10 seconds, until you feel a gentle stretch.
5. 90/90 rest position
- Lie on your back with your lower legs on top of an ottoman, chair, couch or low table. Your thighs will be vertical and your shins horizontal. Both knees should be at a 90-degree angle, creating two distinct 90-degree angles in the leg position.
- If this position provides relief, stay for up to 10 minutes and breathe slowly and deeply to relax the nervous system.
You can also do 10 pelvic tilts in this position.
Additional ways to manage sciatic pain
Sometimes the pain from the sciatic nerve can make it difficult to keep up an exercise routine or maintain a positive attitude. Experts offer mental and physical tips for how to manage this condition on the worst days with sciatic pain.
Mental strategies for sciatic pain
Dealing with constant pain can have an emotional impact — from the fear that the pain may never go away to the stress that comes with trying to find ways to alleviate it. Experts say taking it slow and keeping a positive outlook can help.
- Focus on making progress. Royer recommends developing a specific and strategic plan of how you will progress through gentle stretching exercises, movement and activities with the focus placed on the potential benefits like prevention and alleviation of pain.
“The brain is wired to highlight what feels like a threat (pain), and tends to disregard what feels OK and safe,” Royer says. - Don’t wait for the best time “Do not rely on whether it is a “good day” or a “bad day.” When you feel “good,” you can tend to overdo it and pay the price later. When you feel “bad,” you can completely avoid movement and exercise and lose the progress you’ve made,” Royer adds.
- Track your stressors. Royer says it’s a good idea to think about certain people, places or things that sensitize you to the pain, and what or who do not. “Pay attention to the stressors that impact how you feel and do your best to find techniques to help you regulate your emotional response.”
- Experiment with mindfulness techniques. Research shows chronic stress can have negative impacts on both the mind and body. Royer adds that techniques such as breath work, meditation and mindfulness practices help us to mitigate stress by activating the parasympathetic nervous system (PNS), which moves our body from a flight/fight response to a rest/digest response.
Physical strategies for sciatic pain
When you’re dealing with sciatic pain, experts say your body will respond positively to decreasing inflammation and increasing flexibility and strength through gentle exercise.
- Hot and cold compresses. Ice and heat are great for pain management, says Caldwell. She adds that for older adults, heat usually works better because “it’s probably more of a chronic issue, versus something that just came out of the blue.” She explains heat opens the blood vessels and allows inflammation to move.
- Gentle yoga. Caldwell recommends chair yoga stretches and gentle poses (like child’s pose) to open the hips, elongate the muscles and alleviate tension and compression.
- Abdominal exercises. “A strong core is very important for lower back stability — those muscles work together. If your core is weak, ultimately your back is going to be weak. If your core is strong, your back is going to be strong. So finding core exercises that [you] can do while [you’re] standing or seated is really good,” says Caldwell. She recommends sitting in a chair and slowly lifting one foot off the floor at a time or lying down on a mat to do glute bridges (tightening the glute and abdominal muscles to lift the pelvis off the floor).
- Walking. Caldwell says walking for 10 minutes twice a day can be helpful. “Anything that you can do to move your body, especially the lower half of your body. Anything to stretch that nerve out and move a little bit more is going to be better for you.”
When to seek medical advice
Before starting an exercise routine, Caldwell recommends seeking out an orthopedic doctor or chiropractor for an orthopedic testing exam to ensure the pain you’re feeling isn’t from an injury to the disc or your pelvis.
If “you have numbness on the inside of your legs — whether subtle numbness or if you can’t feel anything — that’s called paresthesia, and you need to go to the hospital now,” she says.
Additionally, if you begin experiencing numbness or incontinence you should go to a hospital immediately, she adds.
A note for caregivers
If you’re caring for an older adult with these symptoms, please keep in mind what your loved one may be going through.
“Positive words can really influence and change how they look at the situation,” says Caldwell. She adds that when people have sciatica, they’re generally in extreme pain. “All the muscles they use for walking are connected to the sciatic nerve. So for some people, they can’t even stand up straight, they can’t walk. Encouragement and trying to get them to move some is important.”
A final word on managing sciatic pain
If you’re dealing with what you believe is sciatic pain, it’s important to consult with a medical professional to ensure you’re following the right treatment plan and to rule out more serious conditions.
With your doctor’s blessing, gentle activities like stretching, walking and core strengthening exercises can help alleviate pain and improve mobility. Staying positive and patient during recovery is key, as improvement can take time, and maintaining a hopeful mindset supports both physical and mental healing.
“Embrace doing the things you love to do, even though there may be a bit of discomfort,” says Royer. She adds that with practice and patience, you can transform your fear of movement to finding what movement is safe and enjoyable for you.
Caldwell wants seniors to remember: “You don’t have to live with this pain forever. It’s not necessarily genetic, and there are ways to decrease symptoms and get back to your regular life.”
