What is Sciatica?
The sciatic nerve is the largest nerve in the body.
There are two, each connecting the spinal cord in the low back to the nerves and muscles in each leg. In most people it runs under the piriformis muscle, which is located deep in the buttock area.
Sciatica occurs when the sciatic nerve is compressed or irritated, causing severe lower back pain that travels down the buttock and leg and makes it difficult to move, greatly impacting your everyday life.
Piriformis syndrome also compresses the sciatic nerve, and can cause symptoms resembling sciatica, however, the two are different conditions; sciatica occurs because of an underlying medical condition, like those mentioned below.
What Causes Sciatica?
Sciatica typically develops over time but can sometimes be the result of an acute injury.
Medical conditions and other factors that may cause sciatica include:
- Herniated disc in the lower (lumbar) spine
- Lumbar spinal stenosis
- Lumbar degenerative disc disease
- Muscle spasms
- Inflammation of the lumbar and/or pelvic muscles
- Pregnancy can sometimes cause pregnancy-related sciatica
- Sitting for too long over time, especially on hard surfaces, which can directly compress the sciatic nerve and is sometimes called wallet sciatica or wallet neuritis
- Previous injuries or surgeries to the area, such as a hip replacement
- Long-term, repetitive strain or overuse, whether recreational or occupational, such as truck driving or strenuous jobs like a machine operator
- Sedentary lifestyle
What are the Signs and Symptoms of Sciatica?
Usually, pain is felt in just one leg. Other signs and symptoms of sciatica include:
- Lower back pain
- Buttock pain
- Burning pain that feels knife-like, or like an electric shock
- Shooting pain that radiates from the low back to the buttock and down into the leg
- Tingling, or “pins and needles”
- Pain that is worse with sitting, trying to stand up, bending or twisting, or lying down
Though it is rare, neurological symptoms, symptoms or weakness in both legs, bowel and/or bladder dysfunction, and sexual dysfunction can indicate a serious medical condition such as cauda equine syndrome (nerve damage), infection or spinal tumours, and should be treated immediately.
Concerned about symptoms of sciatica? Book a physiotherapy assessment at your local pt Health clinic today.
How is Sciatica Treated?
If diagnosed early, you will be less likely to develop chronic sciatic pain.
Treatment for sciatica includes:
- Medications (taken short-term to relieve pain and allow participation in physiotherapy), including:
- Non-steroidal anti-inflammatory drugs (NSAIDs), either prescribed, or over-the-counter, such as Advil, Motrin or Aleve (ibuprofen and naproxen)
- Oral steroids, such as prednisone
- Lumbar epidural steroid injections
- Surgery – if surgery is necessary after other less invasive treatments have not helped, physiotherapy is an important part of rehabilitation
Physiotherapy for Sciatica
Physiotherapy is a drug-free and non-surgical treatment that focuses on reducing pain, preventing chronic pain, regaining strength, and increasing mobility and function.
Because sciatica and piriformis syndrome can be easily confused, during your assessment a pt Health physiotherapist will have you go through a series of specific movements, positions, and stretches that are designed to diagnose true sciatic pain from pain associated with piriformis syndrome.
Then, depending on your individual needs, physiotherapy for sciatica can include:
- Stretching, strengthening, and range of motion exercises
- Core strengthening and stability exercises
- Activity modification and functional retraining
- Personalized exercise plan that can be done at home to encourage continuous improvement and progress
- Preventative strategies to help you manage lifestyle, work, and other risk factors
- Patient education, actively involving you in your own recovery, including return to work or sport recommendations
- Occupational therapy to help you function comfortably at home and work
- Cross-disciplinary pain-relieving therapies such as:
Can Sciatica Go Away On Its Own?
Research clearly shows that the sooner you start treatment for pain or injury, the higher your chances of feeling relief quickly and preventing chronic pain.
Without proper treatment or functional retraining, sciatica symptoms are likely to recur.
If you have sciatica, there are things you can do to make daily life easier, including:
- Minimizing or avoiding activities that exacerbate the pain, however, staying as active as possible is important to recovery
- Switching from high-intensity activities like jogging, to low-intensity activities like swimming once the pain is gone
- Applying heat and cold therapy
- Using an ergonomic chair at work and home
Can You Prevent Sciatica?
There are steps you can take to prevent or reduce the chance of developing sciatica, including:
- Exercising regularly, including stretching exercises such as yoga or tai chi, at least 30 minutes every day
- Staying active; avoid staying in one position for too long
- Practicing good posture
- Wearing orthotics and properly supportive shoes for your activity
- Eating a non-inflammatory diet (avoiding sugar, and processed and refined foods) and drinking plenty of water
- Maintaining a healthy weight
- Using an ergonomic chair at work and home
Speak to a physiotherapist about the best exercises for your activities.
Book a Physiotherapist Consult for Sciatica Today
Concerned about symptoms of sciatica? Book an assessment with a physiotherapist today.