Sciatica is a term used to describe nerve pain in the back or leg that is caused by irritation and/or compression of the sciatic nerve. The sciatic nerve originates from the lower back, travels deep into the buttock and down the back of the leg then branches into two nerves, the tibial and peroneal nerves, at the back of the knee.
Sciatica is NOT a medical diagnosis but rather an old fashioned term for radicular pain and/or radiculopathy. Radicular pain is pain caused by a problem at the nerve root which is where the nerve exits the spinal column. Radiculopathy is a weakness or numbness indicating a loss of function that is caused by a problem at the nerve root. Both radicular pain and radiculopathy can exist together but not always. Referred pain is pain from a problem in a muscle, joint or other structure that is felt in a different place to where the problem is. It can reproduce symptoms similar to that of ‘sciatica’.
What Does Sciatica Feel Like?
The symptoms of sciatica are commonly felt along the path of the large sciatic nerve. Sciatica is often characterized by one or more of the following features:
- Pain - sciatica pain is typically felt like a constant burning sensation or a shooting pain starting in the lower back or buttock and radiating down the front or back of the thigh and leg and/or feet.
- Numbness - sciatica pain may be accompanied by numbness in the back of the leg. Sometimes, tingling and/or weakness may also be present.
- Unilateral symptoms - sciatica typically affects one leg. The condition often results in a feeling of heaviness in the affected leg. Both legs may be affected but this is less common.
What can cause sciatica?
Once again it is important to understand that sciatica is a term used to describe a set of symptoms caused by an underlying medical condition and is NOT a medical diagnosis.
Common issues that may cause sciatica include:
- A lumbar disc injury
- Lumbar spinal stenosis
- Spondylolisthesis
- Muscle spasm and/or inflammation of the lumbar and/or pelvic muscles
- Rarely, tumors, blood clots, or other conditions in the lower spine may cause sciatica.
The Course of Sciatica
Often, one particular event or injury does not cause sciatica entirely, but rather it tends to develop over time. Sciatica affects 10% to 40% of the population, typically around the age of 40 years. Sciatica is found to be common in certain types of occupation where physically strenuous positions are used, such as machine operators or truck drivers. Specifically, people who often bend their spine forward or sideways or raise their arms frequently above the shoulder, especially while under load, level may be at risk of sciatica.
The vast majority of people who experience sciatica typically get better within 6-8 weeks with conservative (non-surgical) management. If severe neurological deficits are present, recovery may take longer. An estimated 33% of people, however, may have persistent symptoms up to 1 year. When severe nerve compression is present with progressive symptoms, surgery may be indicated.
However, certain symptoms of sciatica may indicate a serious medical condition, such as cauda equina syndrome, infection, or spinal tumours. These symptoms may include, but are not limited to:
- Progressive neurological symptoms, such as leg weakness
- Symptoms in both legs
- Bowel and/or bladder dysfunction
- Sexual dysfunction
It is advised to seek medical attention immediately if such symptoms develop. Sciatica that occurs after an accident or trauma, or if it develops in tandem with other symptoms like fever or loss of appetite, is also cause for prompt medical evaluation.
How can Physiotherapy help?
As sciatica is due to pressure on the sciatic nerve, treatment is aimed at removing this pressure. Physiotherapy treatment aims to achieve this by reducing nerve pressure caused by stiff spinal joints as well as easing muscular tension in the lower back, buttock and leg.
A physiotherapist may use the following treatment modalities:
- Exercise based therapy
- Spinal mobilisations
- Massage and trigger point therapies
- Education and advice in relation to how to minimise pressure and irritation to the nerve.
As well as the above interventions a home exercise or self-management program including exercises, stretches and other self-implemented interventions like heat packs, spiky ball massage etc. will be designed for you.
If you are suffering with sciatic nerve symptoms or would like your sore lower back or leg assessed book your free assessment with a Physiotherapist or Exercise Physiologist at Back in Motion Aspendale Gardens follow the link here.