Typing out the following words on a search engine- Pain that begins in the low back, radiating to the feet, accompanied by numbness, tingling, an electric feeling- will quickly give you the following result- Sciatica!
While we don’t recommend this as the ideal method for an accurate diagnosis, we have all been there, done that.
Before we move any further, it’s important to establish that Sciatica is a symptom, not a diagnosis in and of itself. It is helpful to use the term, as a reference when talking to your physiotherapist or physician.
The pain, regardless of how and why it came about, can make the simplest of activities a herculean task. For example, toileting, tying your shoe laces, putting on clothes or taking them off etc. A simple leisure activity like walking your dog can be the cause of intolerable pain. With every activity that you are unable to perform independently, there is a sense of helplessness that grows.
When you feel distressed it’s helpful to remember that pain, as uncomfortable as it feels, can be very useful. It’s your body speaking to you. Your body is signalling to you that it needs an intervention. You know it’s now time to seek out a physician or physiotherapist.
That’s great news because you can now work with your health care team to recover. In a vast majority of cases, with the right physiotherapy intervention, sciatica symptoms resolve in a couple of weeks.
If you’re feeling disempowered, remember the first and most important step you can take is acknowledge your symptoms and seek out medical help. Unfortunately, sciatica does not typically disappear on its own.
What is Sciatica?
Sciatica is the informal term for the condition that refers to an irritation or inflammation of the sciatic nerve. The sciatic nerve is the largest nerve is the body which starts in your low back and goes down to your feet.
The sciatic nerve has multiple smaller nerve branches that originate from it as it goes down to your feet so feeling discomfort anywhere along the back of your thigh and leg are common symptoms.
Causes of Sciatica:
- Sciatica can be commonly caused by a number of different structures that may compress or irritate the sciatic nerve. It is usually caused by a herniated disc or a bone spur which causes a narrowing of your spinal canal (spinal stenosis) which may compress the sciatic nerve. There are also a number of tight muscles and ligaments that may contribute to the compression of the nerve.
- Your physician will help to narrow down the source of the pain and provide a proper diagnosis.
- One of the main causes of sciatica is due to poor motor patterns which lead to hypermobility in the low back. In other words, movement beyond what is required. The low back is mainly meant for stability and not mobility.
- Excessive mobility in the low back will lead to compression of the lumbar disks or development of bone spurs in the spinal joints. Lumbar discs can be likened to being shock absorbers of your spinal cord and they are meant to sit in between your spinal/vertebral bones. In the case of unnecessary movement, the discs may protrude outside the permitted space.
- This protrusion eats into the space meant for the sciatic nerve; the narrowing is often referred to as spinal stenosis. Your sciatic nerve is out of breathing room and gives you information, through the pain, literally asking for its rightful space and wiggle room.
- Poor mobility in the hips, knees, and ankle joints may also cause increased stress in your lumbar spine. Understanding this can be very helpful in prevention altogether.
- Another distinction to be made from Sciatica is Piriformis syndrome. You may hear your physician or physiotherapist use this term.
What is Piriformis Syndrome?
- Piriformis is a muscle in the buttock, around where the sciatic nerve makes its way down from the spinal cord to the feet. When this muscle is tight, it may compress on the sciatic nerve causing similar symptoms to sciatica.
- In rare cases, anatomically and by birth, the muscle is split. This anomaly means the nerve now has to pass through the muscle (instead of behind) which increases your likelihood of developing piriformis syndrome.
- Other times due to trauma, infections or blood clotting in the area, the muscle can pull, stretch or squeeze on the nerve, again resulting in chronic buttock pain that’s radiating in nature.
Physiotherapy treatment for Sciatica and Piriformis syndrome:
A full body assessment will include your upper/mid back, pelvis and hips to determine the best individualised treatment plan. This usually looks like:
- A thorough movement assessment of the entire body with a clear diagnosis and screening for any potential red flags.
- Manual Therapy and/or Dry Needling to aid with symptom management.
- Specific exercise program to target mobility of the body. These exercises can include stretching, strengthening, or neural mobility drills.
- Re-training motor patterns for the entire body.
NOTE: It’s important to exercise extreme caution when doing exercises for sciatica. Sciatica is a complex condition and may need a full assessment from a qualified physiotherapist to prescribe an exercise program.
Common Physiotherapy Treatments for Sciatica:
- Heating or Icing affected area depending on chronicity. Icing is more beneficial for acute stages of a tennis elbow while heat will be more beneficial during the chronic stages. Your physiotherapist will help you decide on the best, current option.
- Medications – Anti-inflammatory medications may help during acute stages to settle down the inflammation. Please consult your local doctor or pharmacist.
- Exercises – the focus is on gentle mobility / stretching exercises.
While this is a general idea of the exercises that can help, unless prescribed to you, do not try them at home. Your physiotherapist will assess your condition and provide 1 or 2 exercises to best help alleviate your symptoms. This blog is intended to educate you on the physiotherapy process for your symptoms.
- Cobra stretch – Hold for 30 seconds, 3 reps, 2xday
- Child’s Pose Stretch – Hold for 30 seconds, 3 reps, 2xday
- Piriformis Stretch – Hold for 30 seconds, 3 reps, 2xday
These stretches, when done under the supervision of a physiotherapist can help relieve pressure on the sciatic nerve thus resulting in decreased pain and increased mobility.
Prevention of Sciatica:
To reiterate, Sciatica can be prevented using a few important strategies. At Revere Physiotherapy we will give you an individualised program. In general, our prevention goals will include:
- Mobility and strengthening entire body.
- Proper form with all complex movements.
- Proper warm-up / stretching before any strenuous activities.
We recommend all clients to get a regular full body assessment every 3-6 months to monitor any possible movement dysfunction.
At Revere physiotherapy, we guarantee the best individualized and hands on approach to your specific goals and lifestyle. Be it gardening or walking your dog, we want to see you get back to doing all the activities that make life wonderful.
Take that first step and book an appointment with our expert physiotherapists. If you have further questions feel free to reach out to us at firstname.lastname@example.org.
We offer complimentary 10-minute phone calls with our expert physiotherapists to answer all your questions.
Call us at 604-566-5108.