Sciatica is a condition commonly treated by physiotherapists and has been found to occur in up to 40% of people who suffer with lower back pain.

Research shows that seeking early intervention for your Sciatica greatly decreases the pain you experience, improves the outcome of treatment and provides you with more satisfaction from therapy.

What causes Sciatica?

The Sciatic nerve is made up of numerous spinal nerve roots that exit the spinal column in the region of the lumbar spine (spine in the area of your lower back). The Sciatic nerve itself, or one of these spinal nerve roots, can be affected by compression or inflammation resulting from an injury to a surrounding part of your body or when the nerve cannot freely move.

Some causes of Sciatica are:

  1. Direct damage to the Sciatic nerve.
  2. Lumbar disc injury or herniation.
  3. Facet joint (small joints on the side of each vertebra).
  4. Narrowing of the canals around the nerve (stenosis).
  5. Arthritis or stiff joints.
  6. Damage to the piriformis muscle in the buttocks.

What are the Symptoms of Sciatica?

If the Sciatic nerve is affected, one of the key symptoms that may cause you to seek treatment is pain that shoots down one side of your leg along the Sciatic nerve. Other symptoms you may experience are:

  • Numbness in an area of the back or leg
  • Changes in your walking or balance
  • Decrease in power of your leg
  • Changes in your posture

How can physiotherapy help?

First of all, your Physiotherapist will perform a thorough assessment, starting with your history and then follow-up with a physical exam in order to determine which body part is most likely causing the symptoms that you are experiencing.

Thereafter, your Physio will focus their treatment on managing your pain and addressing or correcting anything identified during the physical exam. Physiotherapy is an evidence-based profession, meaning that we aim to provide treatments which have been researched and proven to be the most current and effective when treating the condition that a patient may be presenting with.

In the past, bed rest may have been the management of choice when treating back pain and Sciatica, but continued research shows that specific exercises and modified activity can greatly improve the symptoms of Sciatica.

Physiotherapy treatments may include:

  1. Joint mobilisation –a technique used to keep the joints mobile and prevent stiffness.
  2. Soft tissue release – to return muscle and fascia to their original length and keep them flexible.
  3. Strengthening of muscles – strengthening of muscle groups especially the core muscles has been shown to reduce pain and improve function.
  4. Correcting posture and ergonomics – the pain you feel may be affected by the positions or postures that you keep during the day and your physiotherapist can advise you on small changes that will help to reduce your symptoms.
  5. Neural mobilisation – exercises that help to get the nerve moving and improving its ability to glide alongside surrounding tissues.
  6. Advice – understanding why you have your symptoms and how to manage them is a key tool which your physiotherapist can teach you.

This article was submitted by Erin McCall Peat from the Douglasdale branch of Lamberti Physiotherapy. If you think you are suffering from Sciatica, contact her at the Practice, or else complete this easy appointment form to book an assessment.

References

  1. Boote J, Newsome R, Reddington M, Cole A, Dimairo M 2015 Physiotherapy for patients with Sciatica awaiting lumbar mirco-discectomy surgery: A nested, qualitative study of patients’ views and experiences. Physiotherapy Research International 1-9.
  2. Ellis RF, Hing WA, Mcnair PJ 2012 Comparison of Longitudinal Sciatic Nerve Movement With Different Mobilisation Exercises: An In Vivo Study Utilizing Ultrasound Imaging. Journal of Orthopaedic and Sports Physical Therapy 42(8):667-675.
  3. \Jeong U, Kim C, Park Y, Hwang-Bo G, Nam C 2016 The effects of self-mobilisation techniques for the Sciatic nervew on physical functions and health of low back pain patients with lower limb radiating pain. The Journal of Physical Therapy Science 28:46-50.
  4. Reddington M, Walters SJ, Cohen J, Baxter SK, Cole A 2018 Does early intervention improve outcomes in the physiotherapy management of lumbar radicular syndrome? Results of the POLAR pilot randomized controlled trial. BMJ Open 8:e021631. doi:10.1136/ bmjopen-2018-021631.
  5. Stafford MA, Peng P, Hill DA 2007 Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. British Journal of Anaesthesia 99(4):461-473