What is Sciatica?
Sciatica pain is a very common injury to get. Pain normally occurs when there is compression on the sciatic nerve. Pain is usually only on the one side of the body, and it can start in the low back and refer all the way down your toes.
Let’s first look at the sciatic nerve
The sciatic nerve is the biggest nerve in our bodies. Its starts from L4-S3 then it travels through the bum muscles, down the middle of the hamstring muscles, through the back of the knee. From there it splits in to nerves that run down the leg and into the foot. Compression can occur at any of these intersections.
What are the common symptoms of sciatica?
Symptoms can vary from a mild ache to a severe sharp pain with burning or tingling down the leg. People can complain of:
- Low back pain
- Pain in your butt or leg that worsens when you sit
- Hip Pain
- Burning or tingling down your leg
- Weakness or numbness in your leg or foot
- Difficulty to move your foot
- Shooting pain down your leg especially when you stand up
What are the common causes of Sciatica?
- Herniated disks
- Pinched nerve
- Narrowing in the spinal canal (stenosis)
- Bony spur on the spine
- Muscle spasm in your buttock or back muscles
Who is more at risk to get sciatica pain?
- Age – degeneration in the spine that comes from normal wear and tear an cause sciatica.
- Obesity – excess body weight put extra strain on the joints that can speed up the wear and tear process.
- Occupation – Jobs that inquire you to sit for long periods of time put more pressure on the disk and this can trigger sciatica. Jobs that require you to pick up heavy loads can also cause a spinal injury that lead to sciatica
- Diabetes – Diabetes patients struggle with sugar levels that can lead to nerve damage.
When should you see a physiotherapist?
Sciatica may go away on its own but if the pain does not get better you may want to go and see a physiotherapist. Physiotherapist are very good at treating sciatica pain and it is always the first treatment option to try and prevent surgery.
The sooner you get to a physio the better. Your physiotherapist will first do a subjective evaluation to determine what the onset and severity of the sciatica pain is. Thereafter a series of tests will help show where the compression occurs. Massage, fascia release, joint mobilization and exercises are very effective techniques to relieve the compression of the nerve. Core and hip strengthening exercises are also important to make sure that this type of problem does not occur again.
Is it necessary to go for an x-ray or MRI?
Many people have herniated disks or bone spurs that will show up on X-rays and other imaging tests but have no symptoms. Therefore X-rays, MRI or CT scans are not done routinely, unless the pain and symptoms worsen and conservative treatment does not work.
Seek immediate medical attention if you have any of the following symptoms:
- Severe weakness or numbness down your leg, that cause you to fall
- Loss of bladder or bowel control
- Loss of sensation around the bladder area
- Severe pain that makes you feel sick
- Severe night pain that keeps you awake
- Pins and needles in both legs at the same time
The above symptoms could be an indication that there is something serious wrong like compression on the cord. Surgery is normally indicated to prevent permanent damage to the nerve. Surgeons can remove the bone spur or the portion of the herniated disk that’s pressing on the pinched nerve.
How can you prevent Sciatica?
Even though you can’t always prevent sciatica you can definitely do the following to prevent it from happening again.
1) Exercise regularly
- 30 Minute of moderate exercise 3 times a weak has been proven to reduce stress levels. Its also increase blood flow to the muscles and get you up and moving out of the prolonged sitting positions we find ourselves in daily. Also focus on strengthening exercises of the core and hip muscles. This will help to take the load of the spinal joints and disks. Stretches of the buttock muscles and mobilization exercises of the nerve will also help to relieve pain.
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2) Good sitting posture
Maintain a proper posture when you sit. Put a rolled-up towel in the small of your back to get you out of the slouching position and to sit more upright. Slouching puts more strain on the disks that can lead to sciatica.
3) Be mindful of you won body mechanics
When you pick up something heavy, bent you knees, breathe in through you belly and then use you lower legs to come up. Avoid repetitive movements that might aggravate the back. Ex, twisting the one side when you are working. Try and alternate sides and positions.