All You Need to Know About Sciatica

What is sciatica?

“Sciatica” is the term given to symptoms presenting in the legs, originating from the big sciatic nerve (that supplies some of the muscles of the lower leg) being pinched somewhere along its course. Sciatica is not a medical diagnosis as such, but a description of the symptoms arising from other medical conditions such as a herniated (slipped) disc, spinal stenosis (narrowing) or degenerative disc disease. Even an injection in the piriformis muscle (in the buttock) can cause a spasm, which in turn pinches the sciatic nerve.

What are the symptoms?

Sciatica can present with or without lower back pain. Most commonly patients complain of pain over the buttock area, traveling down the posterior/lateral part of the leg, sometimes all the way down to the ankle. Symptoms can also, in more severe cases, include tingling, numbness and even weakness along the distribution of the nerve. Pain is often worse when sitting.

How can physiotherapy help?

Your therapist, as always, will start with a thorough examination in order to determine the cause of the sciatica. He/she may make use of or refer you for radiological examinations like x-rays. In more severe cases you will be referred to a neurologist or neurosurgeon to assist with MRI-scans and surgical intervention if needed.

The trend generally, however, is to attempt conservative measures first. A big role-player is your physiotherapist. The aim will be to address the cause of the sciatica. Modalities of treatment may include the following:

- Reduction of pain and inflammation 

- Spinal mobilisation

- Soft tissue mobilisation around the affected area

- Gentle neural mobilisation

- Exercises and stretches to address any muscle imbalances

- General advice on posture, good movement mechanics and future training