What is sciatica?
Sciatica refers to the type of pain that is caused by the sciatic nerve through irritation or compression. The sciatic nerve is the longest nerve in your body and runs from the lower back, through the buttocks, down both legs and ends at the feet.
What causes sciatica?
The most common cause of sciatica is a herniated disc or disc bulge. This is where the disc which sits between the bones of the spine (vertebrae) becomes damaged and bulges out causing irritation or pressure on the sciatic nerve. Other causes are spinal stenosis (a narrowing of the nerve passages in the spine), a spinal injury, spinal infection or a growth within the spine.
What are the symptoms of sciatica?
If the sciatic nerve becomes irritated or compressed it can cause pain, numbness or a tingling sensation from your lower back and it can travel all the way to your toes. The severity of the symptoms can vary hugely and some people only experience numbness and tingling whereas others may only have pain or you may experience all three. Other symptoms are a weakness in the leg particularly noticeable when walking for example being unable to lift your foot up fully at the ankle to clear the toes of the floor (foot drop). In very rare cases some people experience problems with bladder and bowel control (urinary and bowel incontinence) due to compression on the nerves at the base of your spine. If you are experiencing these symptoms and/or a numbness around your back passage (anus) seek medical advice immediately from your doctor, local walk in centre or A&E.
Diagnosis of sciatica
A thorough subjective and objective assessment will be carried out by your physiotherapist to determine the cause of your pain and to formulate a treatment plan. You will be asked specific questions in relation to your symptoms and specific tailored special tests will rule out/confirm diagnosis.
Since there are many different causes of sciatic pain it is essential to have a thorough assessment by a physiotherapist. The term sciatica simply refers to the type of pain felt not the cause of the pain. Here at AMS we pride ourselves in being able to assess effectively and appropriately to enable us to formulate a treatment and management plan with the goal being to enable effective self-management once specific physiotherapy techniques have been effective.
Physiotherapy treatment for sciatica
Your treatment will be tailored to your needs and will depend on assessment findings. It may include some or all of the following:
- Specific advice and education
- Electrotherapy (ultrasound, interferential, TENS)
- Joint mobilisations and manipulations
- Soft tissue mobilisations
- Specific mobility and flexibility exercises
- Core stability re-training and functional exercises
- Posture re-training and manual handling re-training
- Re-injury prevention advice and education
- Ergonomic advice and education
When to seek help from a physiotherapist
For most people sciatica naturally settles within a few weeks but if you sciatic pain has not settled within two to three weeks it is advisable to seek help as soon as possible. Nerves can be very irritable and if they continue to be irritated can take a long time to settle, therefore early diagnosis and treatment is essential to ensure a speedy recovery. If your symptoms appear to be getting worse rather than gradually improving then it is advisable to seek help from a physiotherapist sooner.
If you are experiencing sudden symptoms of cauda equine syndrome (bladder and/or bowel loss of control and/or numbness of the anus) then seek medical advice immediately from your GP, local walk in centre or A&E.