Sciatica is a specific pain that originates from the sciatic nerves which each run from one side of the pelvis through the hip and buttocks and down the leg. The Sciatic nerve forms what is effectively an electrical cable to and from the brain. Sciatica is a condition where pain, weakness or altered sensation can be experienced in the buttock, hamstring, calf or foot but stem from the spine, via the Sciatic nerve.
What Causes Sciatica?
Although the cause of Sciatica lies in the spine, not all sufferers will experience back pain and symptoms can be variable. The problem can manifest as back pain with leg pain, or leg pain only. The major cause of Sciatica is a Prolapsed Inter Vertebral Disc (more commonly known as a ‘slipped disc’) at the bottom of the back.
Sciatic can be triggered by very small, normal movements like bending over to one side at a bad angle to pick something up, as well from suffering a trauma like falling off a ladder and landing on your back. What happens in all cases is that the sciatic nerve is compressed and consequentially causes you pain. Sciatica can also be caused by stretch type injury as well as gradual onset.
Sciatica is generally caused by compression of nerve roots in the lumbar spine causing pain to the lower back, buttocks and legs, and far less commonly by compression to the sciatic nerve itself, which is the “true” meaning of the term sciatica. One of the primary causes of sciatica is a slipped disc. Other factors however that can cause sciatica include: injury to the buttocks, prolonged external pressure on the nerve, pressure from a tight muscle or nearby structure.
What are the symptoms of Sciatica?
The pain that accompanies sciatica can range from mild to debilitating.
Normal symptoms include:
A sensation of pain.
Weakness, numbness or tingling that generally begins in the lower spine and radiates down through the hips and buttocks and down the leg.
Additional more serious symptoms may include:
Impaired circulation.
Numbness of muscles, or a feeling of weakness, along the nerve pathway in the leg or foot.
Loss of bladder or bowel control.
Difficulty in moving and controlling the leg.
Physiotherapy Treatment for Sciatica
Physiotherapy is very effective in the treatment of disc related problems such as Sciatica. Treatment can relieve nerve root compression caused by fibrous scar tissue following a disc prolapse, or the build up of gas. Physiotherapy also aims to prevent further episodes of sciatic pain through teaching correct postural techniques, and exercises to correct any muscle imbalance in the spine.
Most cases of Sciatica tend to settle down with physiotherapy treatment, but severe cases of Sciatica may require steroid injections or even surgery. Common physiotherapy treatments we use to treat Sciatica are:
Hot and Cold Treatment
Stretching
Regular exercise
Postural advice
Massage therapy including trigger point techniques
Acupuncture
Spinal mobilisation and manipulation