Saanichton Physical Therapy Blog

Sciatica: Causes and Treatment

Sciatica: Causes and Treatment

Sciatica

is the name given to any sort of pain that is caused by irritation or compression of the sciatic nerve.

The sciatic nerve is the longest nerve in your body. It runs from the back of your pelvis, through your buttocks, and all the way down both legs, ending at your feet.

Signs and symptoms

When the sciatic nerve is compressed or irritated, it can cause pain, numbness and a tingling sensation that radiates from your lower back and travels down one of your legs to your foot and toes.

The pain can range from being mild to very painful, and may be made worse by sneezing, coughing, or sitting for a long period of time.

Some people with sciatica may also experience muscle weakness in the affected leg.

While people with sciatica can also have general back pain, the pain associated with sciatica usually affects the buttocks and legs much more than the back.

When to see your GP

Most people find their sciatic pain goes away naturally within a few weeks, although some cases can last for a year or more. You should see your GP if your symptoms are severe or persistent, or are getting worse over time.

Your GP will usually be able to confirm a diagnosis of sciatica based on your symptoms and recommend suitable treatments. If necessary, they can refer you to a specialist for further investigation.

You should immediately call 999 for an ambulance if you experience loss of sensation between your legs and around your buttocks and/or loss of bladder or bowel control. Although it is rare, these symptoms can be a sign of a serious condition called cauda equina syndrome.

What causes sciatica?

In the vast majority of cases, sciatica is caused by a herniated or “slipped” disc. This is when one of the discs that sit between the bones of the spine (the vertebrae) is damaged and presses on the nerves.

Less common causes include spinal stenosis (narrowing of the nerve passages in the spine), a spinal injury or infection, or a growth within the spine (such as a tumour).

You can minimise your risk of developing a slipped disc or back injury that could lead to sciatica by adopting a better posture and lifting techniques at work, as well as stretching before and after exercise, and exercising regularly.

Read more about the causes of sciatica and preventing sciatica.

How sciatica is treated?

Many cases of sciatica will pass in around six weeks without the need for treatment.

However, a combination of things you can do at home – such as taking over-the-counter painkillers, exercising and using hot or cold packs – may help reduce the symptoms until the condition improves.

In more persistent cases, you may be advised to follow a structured exercise programme under the supervision of a physiotherapist, have injections of anti-inflammatory and painkilling medication into your spine, and/or take stronger painkiller tablets.

In rare cases, surgery may be needed to correct the problem in your spine.

Treating sciatica

Treatment for sciatica is not always necessary, as the condition often improves naturally within around six weeks.

However, if your symptoms are severe or persistent, a number of treatments are available.

These usually include self-help and conservative treatments, such as medication and physiotherapy, although it’s not clear exactly how effective many of these treatments are in treating sciatica.

In a small number of cases, surgery may be recommended to correct the problem in your spine that is thought to be causing your symptoms.

Self-help

There are a number of things you can do yourself to help reduce troublesome sciatica symptoms. These include remaining as active as possible, using hot or cold compresses, and taking simple painkillers, such as paracetamol or ibuprofen.

Exercise

If you have sciatica, it’s important for you to remain as physically active as possible.

Simple exercises, such as walking and gentle stretching, can help reduce the severity of your symptoms and strengthen the muscles that support your back.

While bed rest may provide some temporary pain relief, prolonged bed rest is often considered unnecessary and unhelpful.

If you have had to take time off work due to sciatica, you should aim to return to work as soon as possible.

Compression packs

Some people find that using either hot or cold compression packs on painful areas can help to reduce the pain.

You can make your own cold compression pack by wrapping a pack of frozen peas in a towel. Hot compression packs are usually available from pharmacies.

You may find it effective to use one type of pack followed by the other.

Physiotherapy

In some cases, your GP may recommend a suitable exercise plan for you, or they may refer you to a physiotherapist.

A physiotherapist can teach you a range of exercises that strengthen the muscles that support your back and improve the flexibility of your spine.

They can also teach you how to improve your posture and reduce any future strain on your back.

What physiotherapists do?

Physiotherapists help people who’ve been affected by injury, illness or disability. Some of the approaches they use include:
•movement and exercise – taking into account a person’s current level of health and their specific requirements
•manual therapy techniques – where the physiotherapist helps recovery by using their hands to relieve muscle pain and stiffness, and encourage blood flow to an injured part of the body
•aquatic therapy – a type of physiotherapy carried out in water
•other techniques – such as heat, cold and acupuncture to help ease pain

 

http://www.nhs.uk/Conditions/Sciatica/Pages/Treatment.aspx