Sciatica Pain Relief

A regular routine of hamstring stretching is an essential part of almost all sciatica treatment programs. Like all physical therapy and exercise, it is important to use the correct form and posture while performing the stretches.

The hamstrings are a group of 3 long, large muscles—the semitendinous, semimembranous, and biceps femoris muscles, located in the back of the thigh.1 They run from the pelvis down to the knee and help bend the knee and extend the hip. These muscles also control the alignment of the pelvis and spine.2 Because most daily activities do not stretch the hamstrings, they are often overly tight and specific stretching exercises are needed to keep them healthy and flexible.

Tightness in the hamstring muscles can place increased stress on the lower back,1 causing or aggravating some of the conditions that lead to back pain and sciatica. Postural changes occur as a result of tight hamstrings, which may result in lower back and leg pain, including hip, knee, and/or ankle pain.2

Stretching and loosening the hamstring muscles can help relieve sciatic nerve root pressure and improve lower back pain. Hamstring stretches are easy and can be done at home or in office. Depending on the pain and comfort level, stretches can be performed while standing, sitting, or lying down.

This article provides a comprehensive review of the role of the hamstring muscles, hamstring stretching advice, and specific exercises commonly recommended to relieve sciatica pain.

Causes of Tight Hamstrings

The 3 muscles comprising the hamstrings gradually lose their flexibility with age. Tightness begins to develop during early childhood, slowly increasing over time due to a change in elasticity and decreased level of physical activities that involve these muscles.1

In general, women have more flexible hamstrings than men of the same age, which is likely due to anatomical variations in joint structure and also the performance of more rigorous physical work by men, resulting in greater micro-trauma to these muscles.1

Routinely participating in high-intensity sports that involve running, sprinting, and abrupt leg movements, such as basketball and tennis, are common risk factors for hamstring tightness. Sports medicine specialists commonly recommend stretching the hamstrings before engaging in such type of sports while counseling athletes on injury prevention.

How Tight Hamstrings Affect the Sciatic Nerve

The hamstring muscles play an important role in supporting the mechanics of spinal movements, especially during flexion (forward bending). When the spine bends forward, loads are distributed evenly between the lower back and the hip to facilitate a smooth bending movement.3

When the hamstrings are tight, the biomechanics of the lower spine and hip (pelvis) are altered. Over time, the following changes tend to occur:

  • The pelvis tilts forward4
  • There is an increase in the curvature of the lower spine4
  • The mobility and load on the lower spine are increased during forward bending movements3

Increased spinal loads, abnormal curvature, constant movements, and repetitive stress on the lower back may cause sciatica to occur when the lumbar and/or sacral nerve roots are irritated.

How to Identify Tight Hamstrings

The hamstring muscles originate in the ischial tuberosity, a rounded bone at the bottom of the pelvis, and inserts into the upper part of the back of the tibia (the larger of the two leg bones). When these muscles contract, they bend (flex) the knee and straighten (extend) the hip.

Stretching the hamstrings would require the knee to be straightened and hip to be bent forward. If this maneuver is painful, it is safe to assume that the hamstring muscles are tight. Tension in these muscles can be assessed by extending the knee in a sitting position.

A quick test to check for tightness in the hamstrings can be done by following these two steps5:

  1. While sitting straight on a flat surface with the knees bent and feet flat on the ground, one knee is slowly straightened
  2. If the hamstrings are tight in the extended leg, the person will lean backward (extend the hip) into a reclining position to reduce tension in the tight hamstring

This posture is also called a tripod sign or flipping sign because the patient usually places their arms behind to support the trunk, creating a tripod.5


As a general guideline, if there is significant pain while stretching, it is advisable to stop the stretch. Nerve pain or an escalation of sciatica symptoms should not be experienced during any stretching exercises. If any pain or increase in sciatica symptoms is experienced, it is advisable to stop the stretches and consult with a physical therapist or spine specialist.

If regular hamstring stretching continues to be difficult, the stretching may be done as part of a water therapy program. Warm water in a pool provides both support and gentle resistance, which in turn makes stretching less stressful with little or no pain.

Hamstrings are an important group of thigh muscles that play an essential role in stabilizing the spine during movements such as forward bending.6 Since bending movements are common during daily activities, it is essential to keep the hamstrings healthy to prevent injury to the lower back and the sciatic nerve.



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  • 2.Alshammari F, Alzoghbieh E, Abu Kabar M, Hawamdeh M. A novel approach to improve hamstring flexibility: A single-blinded randomised clinical trial. S Afr J Physiother. 2019;75(1):465. Published 2019 Apr 23. Available from:
  • 3.Hasebe K, Okubo Y, Kaneoka K, Takada K, Suzuki D, Sairyo K. The effect of dynamic stretching on hamstrings flexibility with respect to the spino-pelvic rhythm. The Journal of Medical Investigation. 2016;63(1.2):85-90. doi:10.2152/jmi.63.85
  • JH, Kim TH. The treatment effect of hamstring stretching and nerve mobilization for patients with radicular lower back pain. J Phys Ther Sci. 2017;29(9):1578–1582. Available from:
  • 5.Kreder HJ, Jerome D. THE HIP. In: Fam’s Musculoskeletal Examination and Joint Injection Techniques. Elsevier; 2010:45-63. doi:10.1016/b978-0-323-06504-7.10005-3
  • 6.Jandre Reis FJ, Macedo AR. Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during Forward Bending. Asian Spine J. 2015;9(4):535–540. Available from: