Sciatica is a term that many have heard of. Unfortunately, plenty have also experienced symptoms associated with this painful condition. But what exactly is sciatica, and how can Physiotherapy help?
Sciatica, refers to symptoms related to irritation or compression of nerve roots which comprise the sciatic nerve or direct compression of the sciatic nerve itself. This can cause symptoms such as back pain which radiates to the thigh, leg and foot, with more severe cases also causes numbness, weakness and loss of reflexes.
A quick lesson in anatomy.
The sciatic nerve is a thick, long nerve formed by many nerves of the lower spine coming together. The sciatic nerve plays many important roles in the lower limb, including supplying muscles in the back of the thigh and leg and providing sensation to regions of the thigh, leg and foot.
What causes sciatica?
It’s important to note that most sciatica is not related to direct compression of the sciatic nerve itself, rather, compression of a nerve exiting the spine which will eventually contribute to the sciatic nerve. This is commonly the L4, L5 or S1 spinal nerves and can be caused by the presence of protrusions in spinal discs or bony spurs. Sometimes, sciatica can be a symptom of more severe conditions, such as cauda equina syndrome or cancer of the spine. This is why a physio will always ask lots of questions and conduct a thorough assessment when a patient presents with back pain which radiates to the leg.
How can physiotherapy help?
The first job of a physiotherapist is to conduct a thorough examination. A good assessment assists a therapist in deciding if physiotherapy will be helpful, or if other intervention is required first. This will involve lots of questions about the problem, such as when the pain started, what makes it better or worse and clarifying the nature of the symptoms: such as the type of pain and if there is any associated numbness or weakness present. A good therapist will always ask some awkward questions too, including enquiring about bowel and bladder motions and sexual dysfunction, as these issues can be signs of a more serious cause.
Physiotherapy management can assist in providing relief from sciatica through a range of treatments. Broadly, these can be divided into ‘hands-on’ and ‘hands-off’ treatment techniques. From a ‘hands-on’ perspective, techniques such as massage, dry needling and joint mobilisation can be employed to provide relief and improve function at the spine and other problematic areas. ‘Hands-off’ management typically involves the prescription of exercise, including stretching and strengthening exercises. Additionally, exercises specific to the sciatic nerve can be employed, including ‘nerve flossing’ exercises such as the exercise below.
Whilst the prognosis of sciatica can vary greatly from person to person, most people can make a full recovery without the need for invasive procedures such as surgery and injections. Additionally, expensive medical imaging techniques are not required in the absence of impaired muscle strength, progressive sensation deficits or loss of reflexes.
If you or someone you know is living with sciatica, you can contact me directly at email@example.com or the team at Prosper Allied Health Group to make an appointment at https://www.prosperhealthgroup.com.au/physiotherapy or (03) 5290 5238.