Physio for Sciatica
Sciatica is a common condition often thought of as being caused by a torn or protruding disc in the lower back irritating the sciatic nerve. Whilst this is sometimes the case, there are several other less serious reasons that can result in people experiencing sciatic like symptoms. Regardless of the cause, sciatic like symptoms can be broad ranging from low level discomfort through to significant pain and loss of function. Sciatica typically involves pain travelling along the path of the ‘sciatic nerve’ which travels from the lower back, through the rear of the thigh and down the back or side of the lower leg, sometimes even to the foot. The sciatic nerve is the longest nerve in the body and irritation or pinching can cause a widespread distribution of symptoms.
Causes of Sciatica
Sciatica is usually a result of the root of the nerve being compressed at the site where it leaves the spine. There are a few causes of sciatica. A common cause is pressure form a herniated disc. Other causes include compression of the nerve from local swelling, nerve irritation and local joint inflammation. Younger people usually suffer from sciatica as a result of a prolapsed intervertebral disc, and in older adults it can be due to osteoarthritis and changes that have occurred within the spine. Other causes of sciatica include:
- Poor posture
- Herniated disc
- Spinal stiffness
- Unaccustomed bouts of heavy lifting
- Long term abnormal loading habits through the hips and knees
- Prolonged sitting
- Bone disease or local injury
The good news is the majority of sciatic like symptoms are non-structural or only mildly structural meaning they are non-surgical and respond well to physiotherapy treatment.
The Symptoms of Sciatica
Sciatica pain often starts in the lower back and spreads down the buttock, leg and calf. Sometimes the pain can reach the foot. The pain varies from an aching or burning sensation, to sharp, shooting pains. There may also be numbness, muscle weakness or tingling in the leg.
Diagnosing and Treating Sciatica
Sciatica is diagnosed based on symptoms, pain behaviour and a thorough examination. Your physio will test for muscle weakness and pay particular attention to where the pain is located. You may also be referred for an x-ray or CT scan if there is an indication of high level structural involvement. This can be arranged by your physiotherapist or GP if there is a clinical concern to justify imaging. In cases where there is no strong indication of structural involvement imaging is best avoided as it usually only shows up normal age related observations.
Physio for sciatica aims to calm down the sciatic nerve and improve mobility in the spine thereby reducing pain and discomfort. This is achieved through a variety of interventions such as:
- Massage and/or dry needling to reduce tightness
- Spinal joint mobilisation to restore mobility
- Stretching advice and guidance
- Exercise advice to minimise pressure on the injured region
- Assessment and advice on preventing future episodes
- Postural advice
Physio for sciatica is performed through a series of phases.
Initially the focus is on relieving pain and calming the irritated nerve. Once the pain and inflammation has begun to settle, the next phase is to begin restoring strength, flexibility and normal posture. This can be achieved using manual treatment techniques specific to you and exercises guided by your physiotherapist. This will be clearly explained to you by your physiotherapist for each stage of the recovery so you understand why the exercises are appropriate for you.
The final phase has a focus on returning you to your normal daily activities while ensuring that you regain normal movement patterns. To reduce the risk of sciatic episodes in the future, completing your rehabilitation is recommended. We take the time to provide you with advice and strategies to prevent future problems. In addition to fine tuning mobility and strength exercises, we will help you to learn self-management techniques so you can return to your leisure and sporting activities with confidence.
Physio for back pain is an effective way to settle sciatica and reduce the risk of future episodes. Your physiotherapist will identify a treatment approach to ensure you achieve relief from your pain and discomfort. They will also guide you through an exercise program to suit your specific needs and stage of recovery.