Overview
Sciatica is a condition characterized by pain in the lower back, hips, buttocks and legs. It is caused by irritation of the sciatic nerve. The severity of the pain can vary, but most cases are temporary and can be treated with several weeks of therapy.
What is sciatica?
Sciatica is a common condition that causes nerve pain, typically starting in the buttocks and traveling down the leg. The pain is caused by irritation, inflammation, or compression of the sciatic nerve, which comes from the lower back through the hips and to leg. While the nerve itself is rarely injured, it can become irritated or pinched in the lower back, leading to symptoms such as pain, muscle weakness, numbness, and tingling. These symptoms can range from mild to severe and can affect the lower back, hips, legs, and feet.
What does sciatica pain feel like?
Sciatica pain can vary in type and intensity among sufferers. It may be described as sharp, shooting, jolting, burning, electric or stabbing. The sensation often worsens when standing up, twisting one’s torso or sitting for long periods of time—as well as during activities such as coughing or sneezing. Certain quick movements can also cause a flare-up of the pain, which usually is more severe in the leg than in the lower back.
What are the risk factors for sciatica?
You are at greater risk of sciatica if you:
- overweight:
- Lack a strong core:
- Have an active, physical job:
- Lack proper posture in the weight room:
- Have osteoarthritis:
- Lead an inactive lifestyle:
Is the weight of pregnancy the reason why so many pregnant women get sciatica?
Sciatica during pregnancy is common, however, this does not mean its caused by the baby’s weight. Instead, hormones released during pregnancy cause your ligaments to become relaxed. Ligaments play an important role in stabilizing the spine and shielding the disks – when these become loose, it can lead to a slipped disk which pinches nerves and causes sciatica pain. Additionally, the position of the baby may add additional pressure on the nerve. Fortunately, there are treatments available to help alleviate discomfort such as physical or massage therapy, warm showers and heat applications as well as certain medications. To ensure optimal relief, pregnant women should remember to maintain good posture at all times.
Risk factors
Risk factors for sciatica include:
- Age
- Obesity
- Occupation
What causes sciatica?
Sciatica can be caused by several different medical conditions
Herniated or slipped disks are a common culprit for sciatica, affecting 1% to 5% of United States citizens at any one time. This occurs when the pads located between vertebrae in the spine protrude through weak spots and put pressure on nerve roots. Natural wear and tear on the cushioning disks around your spine can contribute to degenerative disk disease, resulting in spinal stenosis: a narrowing of the spinal canal that compresses the sciatic nerve as it exits. In addition, one vertebra sliding out of position relative to its counterpart above it also contributes to this pinching effect. Osteoarthritis can lead to bone spurs (jagged edges) and cause compression of lower back nerves while traumatic injury and tumor growths in the lumbar canal can also compress the sciatic nerve. The most common neuromuscular disorder is Piriformis Syndrome, which is characterised by tightness or muscle spasms in muscles deep within the buttocks leading to irritation of the sciatic nerve.
How is sciatica diagnosed?
Your healthcare provider will start by taking a look at your medical history and inquiring about any symptoms that you may have. A physical exam will follow, which will involve activities such as walking to analyze how your spine bears your weight as well as tests like the straight leg raise: while laying on your back, each leg is brought up one at a time while the provider notes when pain starts. The point where discomfort sets in helps determine which nerve is affected and if there are problems with the discs. Additionally, you may be asked to do certain stretches or motions in order to observe where the pain is located, or check for muscle strength and elasticity. Depending on what’s discovered during the physical examination, further imaging or other tests may be recommended.
. These may include:
- X-rays to check for spinal problem, disk problems, infections, tumors, and bone spurs.
- To see detailed images of the back’s bones and soft tissues, (MRI) or computed tomography are used. An MRI can show burden on a nerve, disk herniation,
- Study of nerve conduction velocity/electromyography to determine how well electrical impulses move along the sciatic nerve and how muscles react. Myelogram to determine if a vertebrae or disk is causing the pain.
Complications
- Weakness and Loss of feeling in the affected leg
- Loss of bowel or bladder control
How is sciatica treated?
- Appling ice or hot packs
- Taking over-the-counter medicines
- Performing gentle stretches
- Physiotherapy
Other treatment options include:
- Prescription medications:
- Spinal injections:
Prevention
- Exercise regularly.
- Keep good posture when sitting
- Use your body correctly
How can my Physiotherapy help me?
1) The early stages of sciatica treatment focus on reducing your pain with physiotherapy, dry needling, nerve stretching, and spinal motion work to lessen irritated nerve sensitivity. In a few visits, this usually results in significant relief and reduced symptoms.
2) We strive to ensure lasting results by developing a personalised rehabilitation plan. Our 3-stage approach (early, mid and late) ensures we address sciatica in an effective manner. Our primary aim is to attain pain relief for you, but the attention to detail throughout the process is what sets us apart from our competition. This involves strengthening exercises targeting muscles supporting your lower back and buttocks which are essential for maintaining adequate body functioning during daily activities or leisure sports. Furthermore, nerve mobility exercises to facilitate movement of nerves as well as spinal mobility exercises to promote flexibility of spine are applied as part of a comprehensive long term management plan.
3) After a bout of sciatica, even once the pain has subsided, you may still experience weakness which can impact your daily activities. To get back to your normal self, a physiotherapy assessment is highly recommended. Our treatment plans typically include advice and education on positioning, posturing and appropriate activity levels which will help you accomplish what you need while avoiding aggravation of symptoms. We also provide guidance on gradually increasing activity as desired in a safe manner.