What is Sciatica?
Sciatica is the name for pain that starts in your back and goes down your leg. Sciatica is characterised by pain that travels along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Some branches of this nerve also go as far as the calf and foot. Sciatica pain can be anywhere along the nerve pathway and can vary from a mild ache to a sharp, burning sensation. Sometimes, this nerve pain can feel like a jolt or electric shock. Usually, sciatica affects only one side of the body. Some people also experience numbness, tingling, or muscle weakness in the affected leg or foot.
What Causes Sciatica
Sciatica most often occurs when a herniated disk or an overgrowth of bone around a joint in the spine puts pressure on part of the nerve. This causes local inflammation, pain, and often some numbness in the leg on the the affected side. Age-related changes in the spine, such as herniated disks and bone spurs, are the most common causes of sciatica. Sometimes, an acute injury to the lumbar spine can also cause sciatica. These injuries can occur from bending and twisting and even gym exercises. Occasionally there can be other reasons for this nerve compression including cysts or other lesions. Anything that presses on the sciatic nerve, or on one of its nerve roots, can cause symptoms. In most cases, the problem is in the spine — even though you feel the pain in your leg.
Physiotherapy for sciatica aims to alleviate pain, promote healing, and prevent future flare-ups. For most people, sciatica responds to self-care measures. This means getting good advice on postures and positions and activity modification. Although resting for a day or so may provide relief, prolonged inactivity can make symptoms worse. Your physiotherapist can provide you with good advice and movement strategies to best manage your sciatica. This may include how to return to work safely or advice on ergonomics and activity.
Over-the-counter pain relievers like ibuprofen and paracetemol can be useful. If you have any concerns regarding the use of these medications then make sure to consult your GP or pharmacist. For other medication, discuss with your GP the use of stronger anti-inflammatories and analgesia.
Physiotherapy for sciatica
Physiotherapy is also recommended for the management of sciatica. A physiotherapist can provide you with advice and education to manage your symptoms, develop mobility and stretching routines, and even implement therapeutic exercise programs. These strategies can help to improve your posture, relieve pain, reduce muscle spasms, and restore the function and movement of the lumbar spine. Specific movements to help mobilise and nourish the nerve can also be very effective to relieve pain.
In some extreme cases if the pain doesn’t improve with self-care measures and medications, surgery might be necessary. Surgeons can remove the bone spur or the portion of the herniated disk that’s pressing on the nerve. However, surgery is usually done only when sciatica causes severe weakness, loss of bowel or bladder control, or pain that doesn’t improve with other treatments like Cortisone Injection.
Here are some key takeaways to help reduce sciatica pain:
- change positions frequently
- rest can be useful for symptoms in the first few days, and its ok to alleviate pain!
- staying active and moving is important for your recovery
- medications can be useful, but use them under the guidance of your GP
- mobility, flexibility and strength exercises can be useful to alleviate symptoms
- follow the guidance and advice of your physiotherapist / doctor
Remember, it’s important to consult with a healthcare professional for an individualised diagnosis and treatment plan if you are experiencing symptoms of sciatica. Any weakness in muscles of the leg or a change in bladder and/or bowel function is important to act on immediately! Seek urgent help if you experience any of these symptoms. If you have any questions or concerns then make sure to contact our physiotherapy team today and get an individualised sciatica treatment plan.