Author: Jack Andringa-Bate
If you get pain down the back of your leg, there’s a good chance it’s Sciatica. This article will help you understand what Sciatica is, and help you manage your condition.
Sciatica is a type of nerve pain that occurs in the lower limb. The term Sciatica is more or less synonymous with what Physiotherapists refer to as radicular pain; pain that radiates along the line of a nerve, in this case, the sciatic nerve. If the sciatic nerve is irritated it can become sensitised, which in turn, can cause sharp pain, burning and tingling, although it may exhibit a wide variety of characteristics.
Given its great size and length, the sciatic nerve is unfortunately somewhat prone to injury and clinicians and patients alike are quick to point the finger at this very important structure. In the process, the common term adopted for nerve pain in the back of the legs, largely by default, has become ‘sciatica’, which you may have been given a diagnosis of before. More accurately though, sciatica is a symptom of a problem rather than a precise diagnosis, and understanding the underlying cause is the key to successful treatment.
Essential Anatomy
To understand why we get sciatica it is important to understand some basic human anatomy. The sciatic nerve functions to relay sensory information as well as stimulate muscle activity in the tissues that it supplies, and it supplies a lot of tissues!
Coursing all the way from the lower back, through the buttocks, down the back of the leg before finally branching out below the knee to reach the lower leg including the feet and toes, the sciatic nerve is the thickest and longest nerve in the body.
What causes sciatica?
Given the length of this nerve, it is possible for it to be irritated at multiple sites, however, the most common site of irritation is where the nerve exits the spine. In many cases the cause of this irritation is due to a lumbar disc herniation. Intervertebral disc material can sometimes herniate from where it usually belongs (supporting the function of the spine) to where it doesn’t, (affecting the function of nearby nerves).
Other causes of sciatica include;
- Osteoarthritis of the lumbar spine
- Intervertebral disc degeneration
- Dysfunction in muscles through which the nerve travels (e.g. piriformis or hamstrings)
- Decreased mobility
- Inflammation
- Pregnancy
Physiotherapy treatment
In all cases, sciatic radicular pain indicates that the nerve is irritated somewhere along its length. Skilled Physiotherapists are trained in the assessment and management of these types of problems and can hunt down the underlying cause of sciatic pain.
Once the nature of the problem has been discovered, treatment can commence. Treatment is as individual as people are unique, so there is no one set of exercises that will be effective for every person. General domains that your Physiotherapist will assess and monitor include;
Mobility:
Optimal mobility ensures that the sciatic nerve can move freely from its origin in the spine to where it terminates in the lower leg. Things that work to improve mobility include; massage, joint mobilisations, exercises, and stretches.
Control:
Control refers to the ability of an individual to monitor and adjust their body position and posture through a variety of different settings. When it comes to sciatica, control of the lumbar spine, pelvis, and lower limb are especially important. Your Physiotherapist will assess your control to determine if this is a contributing factor to the problem.
In many cases, control exercises have a beneficial therapeutic effect as they introduce the body to safe and pain-free ranges of motion that the person may not have been aware of.
Strength:
Strength is a big-ticket item when it comes to successful rehabilitation. Strong and resilient tissues promote optimal function and are less likely to become injured. In sciatica the strength of the abdominal and pelvic regions as well as the entire lower limb are important.
Summary
In summary, if you are suffering from sciatica remember these 3 things;
- The sciatic nerve is very large and so problems like sciatica are common.
- Nerve pain responds well to conservative therapy. Non-invasive, exercise-based therapies that address the underlying cause can promote complete resolution.
- Pain is not proportional to tissue damage; even very painful tissues can return to normal function once the underlying cause has been resolved.
If you are experiencing nerve pain in your legs book in with your Physio for a thorough assessment using this link – [Free Initial Assessment]. Once the cause has been identified the road to recovery can begin.
For self-help exercises for treating Sciatica, make sure you visit our Instagram page - “How to Fix Sciatica”. Make sure you follow us on Instagram for more great health and fitness tips and advice.