Sciatica

Sciatica is a common type of pain affecting the sciatic nerve, a large nerve extending from the lower back down the back of each leg. The term sciatica describes a symptom rather than a specific disease or syndrome and explains a condition in which the right, left or both sciatic nerves are irritated or compressed.

Sign and Symptoms:

  • A shooting pain that makes it difficult to stand up
  • Constant pain on one side of the lower back
  • Pain in the leg that is worse when sitting and putting pressure on it
  • Burning or tingling or numbness down the buttock or leg
  • Weakness, numbness, or difficulty moving the leg or foot
  • Sometimes pain or tingling in the foot or toes
  • The pain can be varied from a sharp shocking pain to just an irritating deep dull aching.

 

Causes:

  • Disc Problems- disc herniation bulging on one of the lumbar or sacral nerve roots. This is the primary cause of sciatica, being present in about 90% of cases
  • Lumbar Stenosis -narrowing of the spinal canal in the lower back which cause compression on the nerve
  • Piriformis Syndrome (tightening of the Piriformis muscle at the back of the buttocks which compress the nerve)- not a true sciatica
  • Pregnancy- as a result of the weight of the fetus pressing on the sciatic nerve in sitting
  • Spondylolisthesis- a condition in which one vertebra slips forward over another one
  • Adjacent bone, tumors, muscle,Internal bleeding, infections or injury

Diagnosis:

Physiotherapists usually do some physical examination and get the patient history to find the source of the pain and then according to the cause of the Sciatica he/she is able to plan the treatment. A positive test for sciatica can give a good indication for the plan of treatment. An MRI may be done prior to physiotherapy commences but is not always necessary.

Treatment:

Physio Savvy first solves the source of the problem. If the cause of the pain is disc herniation, a traction to the lower back can release the disc and remove the pressure from the nerve. If the cause is SIJ problem, we usually perform manipulation or mobilization techniques to correct the joint disorder. For piriformis Syndrome, patient will be given some stretching exercises and the physio performs some muscle releasing techniques such as positional release technique or trigger point therapy to remove the pressure on the nerve.

Strengthen the back and core muscles to give a support to his back is key to maintain stability in the spine.

Your physiotherapist will teach the correct way of sitting, rising from sitting and rectify your lifestyle to help you to have a better ergonomics at home and at work. Recommendation of a good mattress and proper insoles may be key to also.

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Parisa Tanoori

Parisa Tanoori

Physiotherapist at Physio Savvy
Parisa is certified with a Bachelor of Science in Physiotherapy from Shiraz University of Medical Science, Iran. She is currently completing her PhD in Sports Medicine with the special interest of Kinesiology taping in Universiti Malaya.
Parisa Tanoori

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Posted in Musculoskeletal Disorders.