Pelvic Floor Therapy for Sciatica Pain Relief
Sciatica is a sharp, shooting, or burning pain that starts in the lower back or buttocks, sometimes traveling down the back of the leg. It can occur when the sciatic nerve is irritated or compressed, often due to muscle tension, or changes in posture, some of which can occur during pregnancy and postpartum. Some of our patients experience sciatica pain so bad they can’t walk—even simple movements feel impossible.
[Image credit: https://www.mayoclinic.org/diseases-conditions/sciatica/multimedia/sciatic-nerve/img-20008248]
Many people think sciatica is just a back problem—but the pelvic floor plays a huge role in how the sciatic nerve functions. While the sciatic nerve doesn’t pass directly through the pelvic floor, its close proximity means that tension or dysfunction in surrounding muscles—especially in the hips and glutes—can contribute to irritation and pain. That’s where pelvic floor physical therapy can help—by addressing the root cause and getting you moving comfortably again.
[If you’re more of a visual/auditory learner, check out this short video from Dr. Christine here].
What Does Sciatica Feel Like?
Sciatica isn’t just back pain—it follows a specific pattern along the sciatic nerve, which runs from the lower spine down each leg. Here are some common sciatica pain symptoms:
Sharp, shooting pain that starts in the lower back or buttocks and travels down the leg
Burning or tingling sensations (like "pins and needles")
Numbness or weakness in the affected leg
Pain that worsens with sitting or certain movements, like bending or twisting
A deep ache in the glute or hip that just won’t go away
You may also experience urinary frequency and constipation, since the sciatic nerve and pelvic floor muscles are so deeply intertwined
For pregnant and postpartum women, sciatic pain is often worsened by changes in posture, hormone shifts, and the extra strain placed on the pelvic floor muscles.
The Link Between Your Pelvic Floor and Sciatica Pain
Your pelvic floor muscles are connected to your hips, core, and lower back—all areas that affect sciatic nerve function. Here’s how pelvic dysfunction can contribute to pain:
Tight pelvic muscles (piriformis, obturator internus) can compress the sciatic nerve.
Weak core muscles (including the pelvic floor) cause instability, increasing strain on the lower back and nerve.
Postural changes during pregnancy or postpartum can misalign the pelvis, irritating the nerve.
If traditional treatments like stretching and pain meds aren’t working, pelvic floor PT could be the missing piece.
How Pelvic Floor PT Helps Sciatica
A pelvic floor physical therapist looks beyond your lower back to find and fix what’s really causing your pain. Treatment may include:
Manual Release – Hands-on techniques to release and mobilise restricted or tight pelvic and hip muscles.
Core & Pelvic Stability Work – Specific targeted strengthening exercises for the TA muscle (deep core) and pelvic muscles for better spinal support.
Postural Training – Correcting movement patterns that strain the sciatic nerve.
Nerve Glides – Gentle mobilization techniques to help the sciatic nerve move freely and reduce irritation.
Exercise Prescription - Assessing which muscles are tight and which ones are weak to customize a home program for you.
Everyone’s body and goals are unique, so a skilled pelvic floor PT will customize your care plan to fit your needs.
Sciatic Nerve Stretches
Here are a few simple sciatica relief exercises you can try at home (but remember, these are most effective when paired with PFPT appointments):
1. Piriformis Stretch (“Figure 4” stretch)-releases tension in the deep hip muscles
Lie on your back with knees bent.
Cross your right ankle over your left thigh.
Gently pull your left thigh toward your chest until you feel a stretch in your right glute.
Hold 20–30 seconds; switch sides.
2. Pelvic Tilts-improves mobility in the lower back and pelvis
Lie on your back with knees bent.
Gently tilt your pelvis to flatten your lower back against the floor.
Return to a neutral position.
Repeat 10–15 times.
3. Nerve Flossing/Glides-encourages sciatic nerve mobility
Sit tall on a chair.
Extend your right leg while flexing your foot.
Slowly lower your chin toward your chest.
Return to the start position and repeat 10–12 times per side.
When to See a Pelvic Floor Physical Therapist
If your sciatic pain is sticking around for more than a few weeks, gets worse with pregnancy or postpartum changes, or isn’t improving with basic stretching, it’s time to get help. Pelvic floor PT can pinpoint the root cause and give you the tools to feel better—without relying on just medication or temporary fixes.
You don’t have to just live with sciatic pain. Pelvic floor physical therapy can help! Let’s create a plan that helps you move with confidence and ease again. Contact us to learn more: info@bostonpelvicpt.com or (813) 540-0639.
