|
What is Sciatica?
Sciatica is commonly misdiagnosed, which can result is either slow or
non-responsive treatment.
Leg pain can have various sources. It can be a local leg injury or it may even be referred from your lower back. The main nerve that travels from your lower back to your leg is your sciatic nerve. Irritation or pinching of your sciatic nerve can cause severe leg pain known as sciatica.
Sciatica describes pain felt along the sciatic nerve, which runs from your lower back, down through the buttock, hamstrings and into the lower leg. The sciatic nerve is the longest nerve in the body. The spinal sections it originates from include L4, L5 or S1. See the diagram below for a general idea where you may feel sciatica symptoms.
Common Causes of Sciatica
Pressure on the sciatic nerve from a herniated disc usually causes sciatica. Otherwise joint inflammation, compression of the nerve from bony arthritic growths or a locked facet joint in the lower spine can commonly cause sciatica.
Contact PhysioWorks or Book Online
Why does Pinching a Nerve Hurt?
Nerves have many functions, transmitting messages around the body, rather like a telephone system. They allow us to feel things that happen to us, such as things we touch or that touch us, hot and cold, and pain, and they cause our body to do things, eg making your leg muscles contract when you want to walk.
When a nerve is squashed, it may malfunction, and we might feel pain, numbness, pins and needles, and we might find our limbs are weak or do not work in the way they should. The nerve may also get inflamed and irritated by chemicals from the disc's nucleus, without surgery.
Pressure on the sciatic nerve from a herniated disc usually causes sciatica. The problem is also termed a radiculopathy, meaning that a disc has protruded from its normal position in the vertebral column and is pinching the root (origin) of the sciatic nerve.
The degree of pain is often "ridiculously" high as well. Less direct nerve pinching e.g. swelling around the nerve is usually a less severe dull ache. However, this can progress into a radiculopathy as swelling increases.
Other things can cause irritation of or pressure on a nerve in the spine. Sometimes this may be a rough and enlarged part of one of the bony vertebrae, brought about by ageing. Rarely, infections and tumours are to blame. Most times the cause is nothing too serious, but one of the reasons for seeing your physiotherapist or doctor if the pain persists is to exclude these serious and treatable causes.
Contact PhysioWorks or Book Online
What are Sciatica’s Symptoms?
Sciatica causes pain that usually begins in the lower back and spreads through the buttock, leg, calf and, occasionally, the foot. The pain can vary between dull, aching or burning sensations and sharp, shooting pains.
Sciatica can also cause tingling, numbness or muscle weakness in the affected leg. It is very important to seek medical attention in these situations as long-term nerve compression can permanently damage the nerve and its function. In these cases your symptoms may become permanent.
One or more of the following sensations may occur because of Sciatica:
- Pain in the rear or leg that is worse when sitting
- Burning or tingling down the leg
- Weakness, numbness or difficulty moving the leg or foot
- A constant pain on one side of the rear calf
- A shooting pain that makes it difficult to stand up
How is Sciatica Diagnosed?
Your physiotherapist or doctor will review your symptoms and your complete medical history.
You're most likely to get sciatica when you're 30 to 50 years old. It may happen due to the effects of general wear and tear, plus any sudden pressure on the discs that cushion the vertebrae of your lower (lumbar) spine.
Your therapist will ask if you have low back pain that spreads to the leg and will test you for muscle weakness in your leg or foot.
They will also want to know if you've had an injury, fever, problems controlling your bowels or bladder, previous cancers and whether you've been losing weight without trying. These answers to these questions are important because if these symptoms are present, the cause of sciatica could be a serious condition, such as a bone fracture or infection.
Your physiotherapist will examine you, paying special attention to your spine and legs. To look for problems in your spinal column and related nerves, your therapist may ask you to perform a series of tests that will check your muscle strength, reflexes and flexibility.
Your physiotherapist may send you for X-rays, or arrange for a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan to check for problems in the spinal vertebrae (backbones) that may be irritating or compressing your sciatic nerve. Most cases of sciatica affect the L5 or S1 nerve roots.
Contact PhysioWorks or Book Online
How Long Does It Take To Fix Sciatica?
Sciatica usually eases after a period of rest and avoiding
aggravating activities. Your physiotherapist can assist to ease your
symptoms via spinal joint techniques, traction, muscle stretches or
even strengthening exercises. You may wish to do Swiss Ball Exercises to exercise at home and avoid future pain and discomfort.
About one in every 50 people experiences a herniated disc. Of these,
10-25 percent has symptoms lasting more than six weeks. About 80-90
percent of people with sciatica get better, over time.
Everyone is different, but most people with sciatica feel better
within six weeks. Pain that lasts longer than six to 12 weeks should
undertake a specific exercise regime. Real-Time Ultrasound Retraining has proven a very successful treatment for sciatica that originates from a lumbar spine or SIJ injury.
Persisting symptoms over six months may require the attention of a surgeon who specialises in treating back pain and sciatica.
Contact PhysioWorks or Book Online
How to Treat Sciatica?
Usually, a brief period of rest from the aggravating activity and physiotherapy treatment will settle the acute pain. Your physiotherapist will perform hands on techniques that address the cause of your sciatica. Techniques do vary depending on whether the problem is a disc or facet joint injury.
In addition to pain-relieving techniques your physio will provide exercises that assist your specific back deficiencies. This may include some loosening, stabilisation or strengthening exercises. Exactly which exercises work best for you will vary depending on the cause of your sciatica. Sciatica is difficult to treat successfully. If in doubt, please consult your physiotherapist.
Starting physiotherapy as soon as possible can be very helpful. To ease inflammation around the nerve, your therapist may recommend that you use either hot or cold packs. They will provide you with exercises that either loosen or strengthen your back. Exactly which exercises work best for you will vary. It is best to seek professional advice prior to commencing an exercise program for sciatica.
As mentioned earlier real-time ultrasound retraining is very successful.
A back brace or corset can provide excellent relief for most sufferers. Those who gain the most benefit are those who find their pain eases when they wrap/bind a towel or sheet (folded-lengthwise) tightly around their stomach and back. If this simple test eases your pain, you should use a back brace in the short-term. Back braces and strong deep core muscles help to avoid a recurrence in the future.
You also may need to take pain relieving drugs, or anti-inflammatory drugs. In severe cases, an injection of a long-acting anaesthetic with a steroid medication can provide relief. Rarely, surgery is required, such as when a bulging disc causes your sciatica.
Contact PhysioWorks or Book Online
More Details about Common Sciatica Treatment Techniques
Contact PhysioWorks or Book Online
When Should You Contact Your Physiotherapist?
Contact your Physiotherapist if sciatica pain grows worse over a few
days, or if it begins to interfere significantly with your daily
activities.
Call your physiotherapist or doctor immediately if you experience
sudden, extreme weakness in a leg, numbness in the groin or rectum, or
difficulty controlling bladder or bowel function. Patients with these
symptoms may have cauda equina syndrome and should seek immediate
medical attention. This condition can cause permanent damage if not
quickly treated.
Contact PhysioWorks or Book Online
What's Your Prognosis for Sciatica?
The vast majority of sciatica cases settle with simple physiotherapy care within a six weeks. For most people, basic preventive measures are enough to keep sciatica from coming back.
A few patients, however, eventually require surgery for sciatica, such as when symptoms are severe, and caused by a bulging disc. However, it is always worthwhile considering all the facts and discuss thoroughly with your health professional.
Contact PhysioWorks or Book Online
How to Prevent Sciatica?
If your life involves a lot of sitting, a back brace or an external ergonomic support such as a Lumbar Roll or Bassett Frame can be very useful in avoiding future bouts.
Following treatment for sciatica, you will probably be able to resume your normal lifestyle and keep your pain under control. However, it's always possible for your disk to rupture again. This happens to about five percent of people with sciatica.
Once the pain of sciatica passes, there are strengthening and postural exercises, stretches and other measures that help prevent its return. Please contact your physiotherapist for specific advice.
Here are some steps you can take in the meantime:
Practice Good Posture.
Stand up straight and stretch yourself upwards “trying to grow as tall as you can”. This will help to turn on your deep abdominal muscles that open the spaces in your spine where your nerves are vulnerable to pinching.
Avoid Postures that Hurt.
Depending on where your nerve is pinched, you may experience pain when sitting, standing, walking or even lying down. It is important to avoid whichever postures aggravate your pain. If it’s painful to sit for more than 5 minutes, limit your sitting to 4 minutes. Take regular breaks to stand and walk around. If you must be on your feet, prop one foot on a small block or footrest, and then switch feet throughout the day. Your body provides heaps of painful hints. Listen carefully and you will recover quicker.
Walk/Swim.
Walking and swimming can help to strengthen your lower back. Lift objects safely. Always lift from a squatting position, using your hips and legs to do the heavy work. Never bend over and lift with a straight back. Look up as you lift.
Use Proper Sleeping Posture.
Take pressure off your back by sleeping on your side or on your back with a pillow under your knees. If you don’t feel pain, you are in the right position.
Avoid Wearing High Heels.
Shoes with heels that are more than 1½ inches high shift your weight forward, excessively arches your back and can further pinch the sciatic nerve.
For more advice about Sciatica, please contact your physiotherapist.
Contact PhysioWorks or Book Online
FAQs about Sciatica
Contact PhysioWorks or Book Online
Helpful Sciatica Products
Contact PhysioWorks or Book Online
|
