Sciatica is a dysfunction of the sciatic nerve that causes sharp shooting pain, numbness and weakness into the buttock and down the leg. It occurs when there is an abnormal impingement on the Sciatic nerve which runs from the lower spine and down along the back of the leg and into the sole of the foot. Its function is to provide control of movement and sensation to the muscles of the buttocks, hamstrings, calf and sole of the foot. Any interference on the sciatic nerve leads to shooting pain, numbness and weakness down the leg.
Sciatica can be caused by the following conditions:
Compression of a bulging disc on the sciatic nerve root in the lower back.
Impingement of the sciatic nerve in the buttock region by overly tight external rotator muscles, a condition commonly known as Piriformis syndrome.
The growth of a tumour within the lower spinal canal which touches the sciatic nerve, (less common)
Fracture to the strong pelvic bone as a result of an accident which can lead to abnormal pressure on the sciatic nerve.
Signs & Symptoms
Pain in the lower back or hip coupled with a burning or tingling sensation down the leg
Pain often starts slowly progressing to a worsened state
Possible Feeling of numbness or pins & needles down the leg referring into the calf muscle and sole of the foot region
Can experience bad leg cramps
Sciatic pain can worsen when laughing, coughing or sneezing
Feeling of weakness in the affected leg, difficulty in bending the knee
Pain is aggravated after periods of standing or sitting down.
Extending the spine backwards and even walking can bring about pain
Sciatic pain often occurs at night-time.
Treatment & Management
When Patients attend my clinic with the symptoms of sciatica, it is essential that I diagnose the exact cause of the sciatic impingement (e.g. disc bulging or Piriformis syndrome). With a diagnosis of the disc prolapsed I can then treat the dysfunctional vertebral of the lower spine in order to reverse the state of the bulging disc. Alternatively if the Piriformis syndrome is evident then treatment to manually release the taut external rotator muscles is necessary.
Other treatment tips for Sciatica include:
Avoid any lifting activities, bending or twisting of your lower spine
If very painful, a maximum of 2 days bed rest
Rest the spine, the use of ice treatment can help to reduce inflammation in the early stages
Ergonomic (posture) program for your spine will be very important.
Swimming after the acute stage along with basic exercises prescribed by your physical therapist can be beneficial
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Clonmel & Thurles.
Contact Number: 086 3275 753
Email your queries to: firstname.lastname@example.org
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Injury Solutions Clinic
Physiotherapy & Injury Rehabilitation Clinic in Tipperary