Sciatica is a common condition that causes pain to radiate in the buttocks and groin, down the back of the leg and into the foot. This pain is the result of compression of the sciatic nerve. The sciatic nerve can be compressed by a herniated lumbar intervertebral disc or as a result of disc space narrowing related to arthritis. Muscle spasm in the gluteal and piriformis muscles in the buttocks can also compress the sciatic nerve and cause pain. In some cases, sciatica may be the result of certain habits, such as sitting with a wallet in the back pocket or prolonged wearing of a tool belt with heavy tools, both of which can cause sciatic nerve impingement.
Pain is usually a deep ache that is hard to localise and may become a sharp pain with certain movements such as going from a sitting position to standing up or with bending and lifting. Pain may be constant or sporadic and may involve numbness, burning or tingling.
In most cases, sciatica can be treated with rest and physiotherapy. As your physiotherapist, we would perform an evaluation to determine your physical condition, pain location and determine the cause of the sciatica.
Pain management is the main focus of your physiotherapy programme. Pain is managed by easing the compression of the sciatic nerve. This can be done by reducing muscle spasm with massage, heat therapy, acupuncture, stretching. Lumbar strapping with rigid or flexible tape can also allow muscles to relax. Gentle spinal mobilisation and specific exercises can help ease the pain caused by a protruding intervertebral disc.
Exercise is important in the treatment of sciatica. Stretching exercises will target the lower back, buttocks and hamstrings to relieve tightness and promote blood flow. Strengthening exercise of the core muscles will help promote better lumbar support and encourage intervertebral disc correct positioning. Water exercises, swimming and walking are also recommended.
We will also retrain you in maintaining good posture and show you how to find comfortable, pain-relieving positions. Instruction in proper body mechanics during bending, lifting and carrying heavy objects is another important aspect of the programme.
Once your symptoms are under control, we will give you a home exercise programme to continue with and make recommendations to prevent recurrence of sciatica. Some of these may include ergonomic adjustments in the work place or perhaps weight loss, as a healthy weight puts less strain on the back.
Come in to Back Pain and Posture Clinic for an assessment to be on your way to being pain free.
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