Sciatica usually starts with a herniated disk in your lumbar (lower) spine. Your vertebrae (the bones that make up your lumbar spine) are separated and cushioned by flat, flexible, round disks of connective tissue. When these discs get worn down -- either because of an injury or just years of use -- their soft centre can begin to push out of the hard outer ring. Sciatica is a condition that causes pain at some point along the length of the sciatic nerve. This can be anywhere along the lumber region, buttock, thigh, calf, and foot causing low back pain.
It is often due to a back complaint and is more common down one leg but can present down both. It is an example of referred pain which is where you feel the symptoms away from the actual cause of the problem ie leg pain from a back condition. Sciatica is where the sciatic nerve, which runs from your lower back to your feet, is irritated or compressed. It usually gets better in 4 to 6 weeks but can last longer. Symptoms can be aggravated when moving, sneezing, or coughing.
Sciatica symptoms are most commonly pain felt at the nerve roots following the spinal canal and can give rise to feelings of numbness, tingling and weakness. Symptoms may appear along the entire length of the nerve or at a particular point along the distribution, such as in the buttocks or calf. The pain can vary from a mild ache to a sharp, burning pain. Sometimes it feels like a jolt or an electric shock. It can be aggravated when coughing or sneezing or sitting for a long time. Usually, sciatica affects only one side of the body.
Back complaints are the main cause of sciatica, such as disc prolapse, bulging disc herniation, arthritis, muscular tension in the buttock region, and postural factors. It can also be related to other conditions affecting the sciatic nerve such as trauma (eg an ankle sprain or over-stretching the nerve around the ankle) or postural (such as sitting with legs crossed and putting pressure on the nerve around the knee). The sciatic nerve in such conditions can become inflamed or tight and therefore gives rise to the symptoms above.
Initially, we have to work out the site and cause of sciatica by completing a full back and leg assessment. Treatment may consist of joint and nerve mobilisations, myofascial release, exercise rehabilitation, electrotherapy, and postural re-alignment. Acupuncture may also be of benefit.
Your sciatic nerve runs from your lower back to the tip of your toes. Your spinal cord transmits information to and from your back and out of your leg via this pathway.
Problems with the sciatic nerve can occur anywhere along the line of the nerve which is close to the spinal column. However, they are most likely to occur where the nerve comes out of the spine. The pain could be caused by bone spurs, a spasm, or friction around the nerve (herniated discs), all of which are intervertebral. Occasionally there is damage to the nerve makeup itself, but usually, nerve injury results from external pressure from another structure. Consequently, structural or functional changes occur within the nerve, resulting in pain or altered sensations. Sciatica can be triggered by the usual causes of injury - overload or underload of structures from a change in activity levels or trauma.
The treatment should be geared toward the primary cause - poor posture needs to be corrected, sedentary posture needs to be corrected, and overload needs to be reduced. Physiotherapy interventions are aimed at reducing pain, restoring movement, and returning patients to normal healthy function. This can be a combination of pain relief, mobilisation, exercises, and sometimes equipment to help support or offload the pain-sensitive structures.
The sciatic nerve carries information to and from the brain via the spinal cord. Movements or sensations are included in this information. When it is not healthy. Any of these functions can be affected, so this could be a pain, altered sensation, altered muscle power, change in posture
The severity of sciatica is very wide-ranging. In mild cases, it can clear within a day or two with no treatment needed. The other end of the spectrum can see some patients suffering for many years despite trying a comprehensive programme of treatments. The vast majority of patients recover within a few weeks/months, though they may get repeat attacks at some point. Physiotherapy treatment can treat during the initial painful phase and reduce the risk of future flare-ups.
We usually recommend patients reduce but not stop normal activity, so short regular walking is usually beneficial
Sciatica is a type of pain, which is essentially caused by an irritated nerve. Symptoms can be made more severe by ignoring the early warning signs and not addressing the underlying cause of sciatica. If in doubt, contact us at Abbey Physiotherapy where we can offer you advice over the telephone or email and book you in for assessment if indicated.
Massage is just one of the various techniques which can help Sciatica. After a detailed assessment, your Physiotherapist will discuss with you the options available to you
Sitting often makes sciatica more painful, as it stretches the nerve in the lower back, making it more irritable and painful. Try lying on your back, side, or front to see if it is more comfortable. You can still perform some functions in these positions, such as reading, using your phone, and chatting with the family.
Yes, sciatica can go away on its own, but if it is getting more severe, or not getting any better after a few days, contact us at Abbey Physiotherapy. We can book you in for a detailed assessment. In rare cases, severe sciatica can cause Cauda Equina syndrome (CES) so it is imperative to urgently speak to a physiotherapist or GP if you experience any symptoms of CES.
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is a pain affecting the back, hip, and outer side of the leg, caused by compression of a spinal nerve root in the lower back, often owing to degeneration of an inter-vertebral disc.Sciatica
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a condition in which the prolonged performance of repetitive actions, typically with the hands, causes pain or impairment of function in the tendons and muscles involvedRSI