What is Sciatica?

Sciatica is a symptom that consists of leg pain. It can vary from a mild ache to an excruciating, shooting pain. The pain might be worse when you sit, sneeze, or cough. Sciatica can occur suddenly or it can develop gradually. You might also feel weakness, numbness, burning or a pins and needles sensation down your leg, possibly even in your toes.

Sciatic nerveSciatica is usually a symptom of a “pinched nerve” affecting one or more of the lower spinal nerves that run down your leg. The nerve might be pinched inside or outside of the spinal canal.

There are a number of conditions which can cause compression or irritation to the sciatic nerve resulting in sciatic pain (Sciatica). For example:

Lumbar disc bulge/herniation/prolapse
Spondylolisthesis
Pirformis Syndrome
Sacroiliac Joint Dysfunction
Degeneratice Disc Desease
Spinal Canal Stenosis
Bony growths (osteophytes)
Tumours
Infections

Physical Therapies can help reduce pain, inflammation and muscle spasms. Physical therapy consists of hands on treatment, exercise, electrotherapy, acupuncture, education and training to learn about correct movements and postures that can best help you and your sciatic nerve. Key things that will be most effective to help relieve and cure your sciatica are:

Massage
A massage not only helps relax the muscles in the back, it can loosen some of the muscles that are affected by the sciatic nerve. It helps circulation in the back, and if you suffer from chronic sciatic discomfort, massage is a good prevention.

Manipulation
Joint manipulation is a hands-on movement technique applied to a stiff spinal or peripheral joint. Your clinician will use a specifically directed manual thrust which is often accompanied by an audible ‘pop’ or ‘crack’. Spinal manipulations can relieve back pain by taking pressure off sensitive nerves or tissue, restoring blood flow, reducing muscle tension, and promoting the release of chemicals like endorphins and serotonin within the body to act as natural painkillers.

Mobilisation
Joint mobilisation is a passive hands-on movement technique applied to a stiff spinal or peripheral joint. A thorough physical examination by your physiotherapist will determine if mobilisation is the most appropriate technique for your particular presentation. Mobilisation involves rhythmic oscillations within a normal range of joint-motion or against a restrictive barrier and is associated with slower loading rates than manipulation.

Acupuncture
Sam Whiteson AcupunctureAcupuncture is the use of small needles placed in specific areas to help relieve pain and inflammation. Acupuncture can reduce muscles spasm and inflammation associated with the sciatic nerve by improving blood flow to the lower back and increasing circulation. It helps relax muscles and may increase flexibility.

Spinal and Pelvic Re-alignment & Postural Correction
You may have tight or weak muscles and some stiff or extra mobile joints (hypermobility) that may be causing you to maintain poor postures and put the sciatic nerve at risk of irritation or compression. Your practitioner can assess for this, and also investigate the straightness of your spinal segments, test for leg length differences and assess the ilium in the pelvis in the case of an ‘upslip’, ‘downslip’ or ‘rotation’ which is a common cause of pain.

Biomechanical Assessment
Biomechanical assessments focus on investigating the way your body moves. This often can help to pin point the cause of your pain and highlight how to correct or eradicate it. This type of assessment includes a thorough examination of the body’s structure, muscle balance and movement patterns.

Core Stability
Spinal & Pelvic PostureThe term ‘core stability’ is used to describe the body’s ability to stabilise the spine and to balance the workload between the deep and superficial muscles of the trunk. The muscles that stabilize, align and move the trunk are predominantly; the abdominals, the back muscles and pelvic floor. The ‘core’ muscles operate at an unconscious level in healthy individuals to protect and stabilize the joints before movement occurs. Good core stability is using the right muscles at the right time at the right intensity to control the trunk appropriately for the task at hand. Your practitioner will assess your core stability and will give you the right exercises improve any disfunction.

Stretching
Stretching can help release muscle tightness, mobilise joint stiffness and improve movement. This can reduce the pain of lactic acid build up from muscle spasm and offload tension from the sciatic nerve. Stretching can also be done to the nerve itself. Performed correctly this can help improve the nutrition and oxygen supply to the nerve itself. In addition, stretching is good for rehabilitation and long-term prevention.

Heat and ice
An ice pack may reduce inflammation that is associated with sciatic nerve pain. Heat helps to increase the blood flow to this area. Alternating both cold and heat can give positive results in reducing pain and inflammation.

Over the Counter Medications
Over the counter medications such as paracetamol or ibuprofen can help reduce pain, inflammation, and act as temporary pain relief.

Prescription Medications or Injections
If the pain gets too intense, some people may require prescribed medications such as muscle relaxants and in some cases, anti-depressants or injections such as epidurals. These medications help by not only blocking the messages of pain the brain receives, it also helps the production of endorphins which is a natural painkiller.

Topical Analgesic
Electrotherapy unitSome people find relief in topical pain relievers. Many of the analgesics contain menthol which can help aid in blocking pain receptors and relax muscle tissue.

Support and Posture
Sitting on hard or uneven surfaces can aggravate the sciatic nerve therefore, making sure there is good support and posture can help. If you sit at a desk, having a chair that tilts and shifts your weight can reduce stress on the lower back. Sleeping with side bent knees can also help align posture while you are sleeping or you can lay with a below under your knees if on your back.

TENS
TENS, or transcutaneous electrical nerve stimulation, works on a principle similar to that of acupuncture. TENS helps the brain to focus on the massage action and electrical stimulation of the low voltage produced by a TENS unit to subsequently help to reduce pain.