What is Sciatica?
Sciatica (otherwise known as radiculopathy) is a term used to describe symptoms of pain that radiates anywhere from the low back down the back of the leg via the sciatic nerve and may go as far as the feet and toes.
The sciatic nerve is the largest nerve in the body. It originates from a bundle of nerves in the lower back (known as the sacral plexus) and passes through the pelvis and down the back of the thigh where it then branches into two smaller nerves, continuing toward the feet.
What causes Sciatica?
There are a number of potential causes of sciatica that can be placed into two categories – inflammation or compression. The pain will occur when the sciatic nerve has been irritated or compressed.
This compression or irritation can be from a herniated disc, disc bulge, spinal stenosis, degenerative disc disease or spondylolysthesis. It can even be caused by muscles in the deep buttock, such as the piriformis muscle, that may be tight or spasming.
Pregnancy can also cause sciatic symptoms if the weight of the growing foetus places pressure on the sciatic nerve.
Other causes include injury to muscles of the low back, infection or tumours (which will be ruled in or out by your therapist).
The most commonly reported symptoms of sciatica are described as:
- Deep, intense and often unrelenting pain that starts on one side of the low back that can continue down the leg
- Cramping sensation in the thighs
- Tingling, numbness or burning sensation in the legs
- Reduced strength in certain muscles of the leg
- Neurological deficit (reduced reflexes)
The pain can vary in intensity and is usually exacerbated by posture or movement – for example, bending backwards, prolonged sitting, sneezing, coughing or laughing.
Depending on severity, symptoms will usually resolve in a relatively short timeframe (days to weeks) if treatment is initiated early enough. More severe cases generally require more extensive treatment and longer rehabilitation.
In many cases, the pain will ease before rehabilitation is complete. It is important to realise that sciatica has the tendency to recur. If there are contributing factors (such as core muscle weakness, joint dysfunction etc) that caused the problem to come about in the first place, your therapist will identify these and provide treatment and advice to minimise your predisposition to future recurrence.
Initially, the main aim of treatment will be to reduce pain. As this is achieved, your therapist will focus on restoring optimal joint mobility, as well as muscle balance, strength and recruitment patterns.
In more severe cases, your therapist will identify any need for scans, or in the most extreme cases, organise for referral through a GP to a surgeon if required. The vast majority of cases, though, are best taken care of without the need for surgery.
If you think you might be suffering from this condition, please give us a call and we’ll be able to provide the correct treatment option for you.