Sciatica

What is Sciatica?

Nobody likes to be in pain, but sciatic pain can be one of the most debilitating conditions to suffer from, since it can affect your back and legs, and often makes it difficult to go about your daily activities – even to sit down.

What is Sciatica?

Sciatica or sciatic neuralgia refers to pain occurring along the pathway of the sciatic nerve, running from the lower back through the hip and down the back of each leg. When the nerve gets injured or compressed, pain occurs originating from the low back, radiating down through the hip, buttocks and leg – sometimes down as far as the foot and big toe.

The pain can vary from dull, aching or burning to sharp and shooting. Other clinical presentations could involve muscle weakness, numbness and tingling.

It is important to have this condition treated as quickly as possible when it first arises because compression of the nerve long term could lead to permanent damage resulting in permanent symptoms.

What Causes Sciatica?

Potential causes of sciatica could include an injury or compression to the sciatic nerve could be due to structural changes such as herniated or bulging discs, lumbar spine facet joint dysfunction or inflammation. Non-structural causes could include fibromyalgia, diabetes, peripheral neuropath or ischemia (inadequate blood supply). To identify the specific cause of a patient’s sciatica would require imaging such as x-ray, CT or MRI scans as well as observation and physical examination.

Treatment for Sciatica

Generally, treatment would be carried out in three phases.

The first phase focuses on relieving pain. Depending on the exact cause of the problem, treatment regimes could range from taking anti-inflammatories, manual manipulation, acupuncture, taping and soft tissue work.

Once the pain and inflammation have subsided, the next phase of treatment would be to focus on restoring flexibility and good posture to prevent injuries from occurring again. Postural awareness with cues like keeping your spine stretched ‘tall’ allows the spaces in our spine to open up and avoid pinching of the nerves.

The last phase focuses on strengthening work and stability exercises like increasing core strength. Other ideal options include swimming or hydrotherapy as buoyancy of the body in water reduces strain on the area. Our other advice would be to try side-sleeping with a pillow placed under your stacked knees so to avoid additional pressure on your back from lying face up.

Unfortunately, sciatica can often reoccur, therefore it is very important to undertake a strong rehabilitation programme that targets core strength, mobility and stability to avoid ongoing symptoms that could potentially become permanent if neglected for too long. Whilst it is important to challenge oneself during strengthening exercises, it is equally important to not overdo things. A good rule of thumb is – if it hurts, don’t do it!

If you suffer from Sciatic pain, the Chiropractors and Massage Therapists at Precision Health at Baulkham Hills can assist you in reducing pain, managing symptoms and ensuring there is no recurrence.

Ropper, AH & Zafonte, RD, 2015, ‘Sciatica’, The New England Journal of Medicine, vol. 372, no. 13, pp. 1240–1248, doi: 10.1056/NEJMra1410151

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