WHAT IS IT? SCIATICA

Sciatica is the common term given to pain which is referred from the lumbar spine.


Depending on the level of spine which is affected, the pain can be present in the back, buttock, or down the leg.  Pain often runs down the back of the leg, but may also affect the groin, front or side of the leg.


Compression of a lumbar nerve can result in this referral.  Nerves can become compressed due to a disc bulge, aggravating chemicals which irritate the nerve or osteophytes which impinge on the nerve.

Signs & Symptoms

  • Acute low back pain

  • Muscle spasm

  • Restricted ability to move

  • Referral of pain or symptoms into buttocks or down leg

  • Pins and needles

  • Numbness

  • Altered sensation

  • Weakness

  • List or lean to one side

  • Possible disturbances to normal gait, bladder or bowel function

The condition is easily aggravated by normal activities including, but not limited to, sitting, turning over in bed, bending down and driving.

What Causes It?

  • Repetitive loading can result in a worn, weakened area of the disc.  This degeneration can eventually manifest into a disc protrusion or herniation.  Often it may only take a trivial action.  The mechanism of injury usually involves flexion and/or rotation, and in some cases compression.

  • Osteophytes can impinge on where the nerve exits the spine

  • Irritation of a nerve can occur from chemicals released by an injured disc.

  • More common between the ages of 20 and 50 years

  • Influenced by repetitive, manual jobs or activities

How to Self Manage

  • Rest in a position of comfort (often laying down)

  • Resting from aggravating work and/or sports will allow the back time to settle and heal

  • As soon as possible normal activities should be attempted to reduce fear of movement

  • Adequate pain management is extremely important, and allows for treatment and rehabilitation to take place more comfortably

Prognosis

  • If symptoms worsen, peripheralise, or affect bladder, bowel or sexual function, then assessment by a GP or A+E is necessary

  • Improvement should be noted within 4-6 weeks.  Long term management should entail ongoing Pilates and mobility exercises

  • Maintenance manual treatment can be useful to prevent recurrences

  • Assessment by a specialist may be required if symptoms do not improve or become worse.

How Physio Helps

Reduce pain and inflammation by:

  • Joint mobilisation

  • Massage

  • Prescribing exercises to restore mobility and improve core stability

  • Electrotherapy

  • Acupuncture

  • Taping

  • Traction (practitioner dependent)

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