Sciatica(Sciatic neuritis, lumbar radiculopathy)
- feet and toes
- bottom
- backs of your legs
- pinched herniated disc
- bone spur on the spine
- narrowing of the spine (spinal stenosis)
- spinal osteoarthritis
- Degenerative disc disease
Description Of Sciatica
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 -- its soft centre can begin to push out from the hard outer ring. Sciatica is a condition which gives rise to pain at some point along the length of the sciatic nerve. This can be anywhere along the back, 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.
The lateral view of the spine
Common Symptoms of Sciatica
Sciatica symptoms are most commonly pain felt at the nerve roots following the spinal-canal can give rise to feelings of numbness, tingling and weakness.
Symptoms may be along the full length of the nerve but it may just be at some point along the nerves distribution, such as in the calf or buttocks.
Causes Of Sciatica
Back complaints are the main cause of sciatica, such as a disc prolapse, bulging disc herniation, arthritis, muscular tension in the buttock region and postural factors. It can also be related to other conditions affecting sciatic nerve such as trauma (eg an ankle sprain over-stretching the nerve around the ankle) or postural (such as sitting with legs crossed 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.
Treatment Of Sciatica
Initially, we have to work out the site and cause of the sciatica by completing a full back and leg assessment. Treatment may consist of joint and nerve mobilisations, myofascial release, exercises 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 and carries information to and from your spinal cord to and from your back and out aspect of your leg.
The location of the sciatic nerve
Problems with the sciatic nerve can occur anywhere along the line of the nerve which is close to the spinal-column but is most likely to occur where the nerve comes out from the spine. Problems can occur caused by bone spurs, as a spasm where the nerve is stretched, compressed or has friction around it (herniated discs) which are intervertebral. Occasionally there is damage to nerve make up itself, but usually, nerve injury occurs from external pressure from another structure causing the structural or functional changes within the nerve and subsequently the pain or altered sensation. Sciatica can be triggered by the usual causes of injury - overload or underload of structures from a change in activity levels or trauma.
Treatment needs to be aimed at the underlying cause - poor posture needs to be corrected, undertaking more activity where the cause is sedentary posture and reduction of activity in the case of overload. 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, about any movement or sensation, 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 to reduce but not stop the normal activity, so short regular walking is usually beneficial
Symptoms can be made worse by ignoring the early warning signs and not addressing the underlying cause of the sciatica. If in doubt, contact us at Abbey Physiotherapy where we can off you advise over the telephone or email and book you in from 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 worse as it stretches the nerve in the lower back, making it more irritable and painful. Trying lying on your back, side or front to see if it is more comfortable in these positions, you can still undertake 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 worse, or not getting any better after a few days, contact us at Abbey Physiotherapy and we can book you in for a detailed assessment In rare cases, severe sciatica can cause Cauda Equina syndrome so it is important to urgently speak to a Physiotherapist or GP if you report any symptoms of CES
Symptoms of Sciatica (Sciatic neuritis, lumbar radiculopathy)
Physiotherapy Treatment of Sciatica (Sciatic neuritis, lumbar radiculopathy)
- help relieve pain by promoting movement of the spine. Often, individuals with lower back pain and sciatica feel relief with specific directional movement of the spine. A physical therapist typically evaluates an individual’s directional preference before prescribing specific directional exercises, as these are tailored to the individual patient and symptoms. These exercises include backward (extension) and forward (flexion) bending.
- bodyweight and resistance exercises to strengthen the muscles of the abdomen, low back, hips, and legs. involve contracting muscles without moving the joints. Examples of isometric exercises include a plank or a bridge hold. These exercises can help strengthen muscles when symptoms are more acute.
- bodyweight and resistance exercises to strengthen the muscles of the abdomen, low back, hips, and legs.include the contraction of a muscle to resist a constant load, such as resistance bands and weight training, to help increase muscle strength through constant resistance to specific motions.
