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Will back bends help with sciatica?

One stretch that has been popularized in the sciatica pain world is the “Mckenzie” back bend. If this term doesn’t sound familiar, then something like a backwards bend, or a press up from the floor might ring a bell. This was coined by Robin Mckenzie, a physiotherapist (Australian physical therapist), who accidentally had one of his patients lie face down on a table that was inclined up. That patient stood up and said that their pain went away entirely. This resulted in the investigation of this mysterious movement and why it was helpful. 

But if you google the cobra press or back extension exercise for sciatica pain, you’ll find an equal amount of articles saying how this stretch can actually make sciatica pain worse. This is utterly confusing and frustrating. 

So what gives? Will this stretch help out with my sciatica? It depends on a couple conditions that are listed below:

  1. A posteriorly herniated disc that is truly the cause of the pain. “Aka, a bulging disc) This can be confirmed via an MRI. If the herniation is towards the side of symptoms, and presents itself along the right level of the nerve root, back extensions may be helpful. It is theorized that the backward bend may “push” the contents back into the disc space itself resulting in pain relief.
  2. If the pain is reduced as a result of this backward bend. There may not even be any MRI evidence of a disc bulge, but the body and nervous system simply just “prefers it”. The only way to find out is to see if it actually helps out with the pain.

A back bend aka “back extension” may not help symptoms if:

  1. There is no herniated disc confirmed via MRI
  2. Too much arthritis growth in the vertebrae. Especially near the intervertebral foramen, aka “the openings for the nerves”. If there isn’t enough room for that nerve to pass, then backward bending may actually close down and pinch on the nerve resulting in pain and irritation.
  3. If the pain increases or spreads out as a result of the backward bend. Again, this is the body telling you that the body does not prefer it and should be avoided for now.

You are the true test if something works or not. So if it hurts more, avoid it; if it feels better, then this stretch could be for you.

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