Sciatica

What is Sciatica?

Sciatica refers to nerve pain occurring due to an irritation or injury to the sciatic nerve. Usually, the pain originates in the buttock, when people experience mild or severe pain in the sciatic nerve. However, pain may also begin from the lower back, and moves through the hips, buttocks and goes down the legs. It causes weakness in the muscles of the foot or leg, pins and needles-like symptoms on the toes, foot, and leg, and numbness in the legs. The pain may come and go, and it is usually more severe in the leg than the lower back, and it may feel more when standing up after long periods of sitting.

The condition mostly occurs when a bone spur or a herniated disk on the spine compresses a part of the sciatic nerve. Although the pain may be severe in this condition, treatment is largely non-invasive. Leg weakness and bowel or bladder changes might require surgery. The condition becomes more prominent with aging.

Plan Consultation

Sciatica refers to nerve pain occurring due to an irritation or injury to the sciatic nerve. The condition mostly occurs when a bone spur or a herniated disk on the spine compresses a part of the sciatic nerve.

Symptoms of Sciatica:

The pain usually moves from the lower part of the spine to the buttock, creating discomfort, and the symptoms are:

  • Numbness in the back of the leg or a tingling weakness
  • Usually, the condition affects one leg and creates a heaviness in the affected area
  • The symptoms of pain and discomfort worse when sitting, trying to stand up after sitting, lying down, twisting the spine, and coughing.
  • Applying hot therapy on the rear pelvic region and walking may relieve pain
  • The pain may worsen with movement in some people
  • Incontinence or the inability to control bladder and bowel may help

Causes of Sciatica:

Several medical conditions may cause this condition, such as:

  • A herniated slipped disk stressing the nerve root
  • Spinal stenosis or when the spinal canal narrows down reducing the availability of space for the nerves and the spinal cord
  • Bone spurs form in the aging spine, compressing the nerves on the lower back
  • Piriformis syndrome irritating the sciatic nerve when the piriform muscle becomes tight
  • Cauda equina syndrome affecting the bundle of nerves at the end of the spinal cord causing pain in the lower leg, loss of bladder and bowel control, and numbness surrounding the anus
  • Spondylolisthesis in which an extended bone causes the nerve to pinch

When to See a Physiotherapist for Sciatica:

Physical therapy, including exercises, is a prominent treatment option for treating the pain due to a compressed sciatic nerve. The therapeutic treatment aims to treat the lower hip and back, leg pain, numbness, tingling sensation, and weakness in the thigh, leg, buttock, and foot. 

The therapy provides relief from the symptoms, boosts the underlying condition's healing, and prevents future recurrence. The physiotherapists are trained to provide manual therapy, rehabilitation, and exercises for low back pain. Strengthening and mobilizing the tissues in the pelvis, lower back, buttocks, abdomen, and the thighs is the primary goal of the therapeutic treatment.

People with this condition need to go to a physical therapist to:

  • Relieve pain in the buttocks, lower back, thigh, and leg
  • Restoration of functionality and inducing pain-free movement
  • Restoring the function of the sacroiliac joint and the lumbar spine
  • Minimize muscle spasms
  • Initiating better healing on the lower back
  • Boosting neurological adaptations to reduce the feeling of pain
  • Improving mobility of the lower body
  • Prevention of future flare-ups and reducing fear associated with movement

The therapist recommends the following exercises:

  • Extension and flexion exercises of the back
  • McKenzie method comprising mechanical diagnosis and therapy
  • Functional retraining
  • Isometric and isotonic exercises
  • Mobilization of the joints and nerves
  • Joint manipulation
  • Dry needling
  • Soft tissue mobilization and myofascial release
  • Assisting patients to restore full range of motion
  • Gait training
  • Muscle energy technique

The therapists may use one or combine a few techniques to treat pain and provide comfort.

Risks of Sciatica:

Complications often develop in this condition when pressure on the pressure on the nerve or spine is not relieved. The risks are:

  • Worsening pain
  • Numbness or weakness in the affected leg
  • Permanent damage of the nerve
  • A slipped or herniated disc
  • Losing bladder and bowel function

When the pinched nerve becomes seriously injured, muscle weakness or drop foot makes walking severely restricted.

How to Prevent Sciatica:

Even though it is a degenerative disk disease that is hard to prevent, the following steps protect the back and reduce the risks.

  • Stop smoking  as nicotine reduces the supply of blood to the bones and deteriorate the condition of the spine and the vertebral disks, stressing them o cause back pain
  • Maintaining suitable posture during standing, sitting, lifting heavy objects, and sleeping releases pressure on the lower back.
  • Regular exercises to maintain flexibility of the joints
  • and strengthen the lower back and abdomen muscles
  • Maintaining safety from accidental falls
  • Choosing physical activities that do not hurt the lower back
  • Maintaining a healthy weight

Treatments of Sciatica:

The treatment options include the following:

  • Prescription medications with pain-relieving action might be given by the doctor based on the severity of the pain and is an early treatment plan
  • Spinal corticosteroid injections with anti-inflammatory properties help in reducing  pain and swelling around the roots of the nerve
  • Physical therapy includes a range of exercises to reduce muscle flexibility and aerobic exercises, such as swimming and walking
  • Alternative treatments to manage pain through acupuncture, yoga, or consulting with a chiropractor

Related Conditions:

Nerve pain or neuropathic pain is caused due to nerve damage, and the types are focal neuropathy, autonomic neuropathy, compression mononeuropathy, diabetic neuropathy, phantom limb syndrome, and trigeminal neuralgia.

Frequently Asked Questions

1. What happens when sciatica worsens?
Severe damage to the sciatic nerve can lead to neurological symptoms affecting one or both legs.
2. Can the condition go without treatment?
Mild or moderate symptoms may go with exercises, but a doctor must diagnose the condition to check whether it may go without treatment.

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