Sciatica is the term given to describe symptoms caused by irritation of the sciatic nerve. Contrary to popular belief, it is NOT a medical diagnosis. The sciatic nerve is formed from spinal nerves exiting the lower back, and runs through the buttock and down the back of both legs. Any pain or symptom experienced along this nerve is referred to as ‘sciatica’.
Common symptoms include:
One sided pain that may be felt in the lower back, buttock, hip and leg. It may also radiate to the foot and/or toes
Pain that can be described as severe, burning, sharp, tingling, searing
Weakness and or numbness in the leg, foot and toes
The problem causing sciatica is actually the correct diagnosis. Common causes include:
Lumbar disc herniation
Degenerative disc disease, osteoarthritis
Spinal stenosis (narrowing of the spine)
Nerve entrapment e.g. from tight musculature surround the lumbosacral area
Most sciatic pain is treated and managed with conservative treatment. As sciatica can be caused by a range of different issues as described above, it is important that an appropriate assessment is performed to provide specific treatment. Not all sciatic pain is the same!
Our physiotherapists will provide a range of treatment which may include:
Advice and education about the condition and how to manage the symptoms, generally exercise and staying active rather than bed rest
Strengthening exercises for supporting muscles e.g. lower back, core, hip
Stretching exercises for tight muscles
Hands on treatment for stiff joints and/or tight muscles
An individualised exercises program for self-management and future prevention.
Most cases of sciatica resolve by themselves within six weeks to three months. Sciatica can also be caused by narrowing of the nerve tunnel between discs due to osteoarthritis. Elderly people who suffer from disk degeneration as a consequence of ageing tend to be troubled the most by sciatica.
If sciatic pain is bothering you, make an appointment with one of our physiotherapists to aid in a correct diagnosis for optimal management.
There is a common belief that there is not much you can do for osteoarthritis because the joint damage has already occurred and can’t be reversed. However it is often the inflammation of the tissue surrounding the joint and instability from the weakened tissues that lead to pain from an arthritic joint.
Our physiotherapists may be able to help you decrease the inflammation and pain around the joint and get you moving again. Here is some information about osteoarthritis and how we can help.
What is osteoarthritis?
Arthritis is a name for a group of conditions that cause damage to the joints in our body, usually causing pain and stiffness
Osteoarthritis is one of these conditions and it affects the whole joint, including bone, cartilage, ligaments and muscles
It is most prevalent in the joints of the hips, knees, neck, lower back, fingers and big toe, but can occur in any joint
It is degeneration of the joint structures, namely the cartilage (protective cushioning on the bony surfaces) and its underlying bone surfaces
Bony growths or spurs commonly known as osteophytes are common in osteoarthritis
Ligaments and muscles around the joint also deteriorate in osteoarthritis
It normally affects a joint on one side of the body i.e. it doesn’t normally occur bilaterally like other arthritic conditions
There are other arthritic conditions you may have heard of such as rheumatoid arthritis, juvenile arthritis, and ankylosing spondylitis.
Signs and symptoms
Swelling of the joints
Symptoms usually develop and worsen gradually over months or years
Affecting ability to carry out normal daily activities
Clicking/grinding in the joint
Loss of flexibility in a joint
What causes osteoarthritis?
Previous joint trauma/injury
Being overweight greatly increases your risk
High joint stress/repetitive use/heavy loads
There is an increase risk as you age and there is more ‘wear and tear’ on the joints
Arthritis can be diagnosed by taking a thorough history and physical examination
X-ray can help confirm a diagnosis – you may need to see your doctor to get a referral
Our physiotherapists can help you with:
Strength and exercise programme
Joint mobilisation/soft tissue techniques
Aids or braces
Weight loss programme
Medication and joint supplements – your doctor can guide you on the best options
Surgical options such as joint replacement
Pre-operative rehabilitation has been shown to improve outcomes post-operatively, so if you are requiring surgery come and find out how you can help speed up your recovery with pre-hab
Some hints for the colder months
Cold weather can exacerbate joint pain and joint stiffness. Remembering a few common sense tips can help people with osteoarthritis survive cold weather:
Dress warmly and layer up
Exercise indoors to stay motivated and warmer
Use a heated pool for exercise – talk to your physiotherapist for local options and classes
Ensure your vitamin D levels are adequate
You don’t have to wait for the warmer months to reduce pain associated with osteoarthritis! Book an appointment with a physiotherapist online 24/7,
Plantar fasciitis is inflammation of the plantar fascia and is the most common cause of heel pain. The plantar fascia is the thick band of connective tissue under the foot that runs from the heel bone at the back of your foot to the toes at the front. It essentially acts like a sling to support the arch of your foot.
What causes Plantar Fasciitis?
There are a number of causes including:
Age as it is more common in middle-aged people due to ‘sagging’ of the arch of the foot, but can occur in younger people who put a lot of load through their feet.Weaknesses can occur in the muscles that support the arch of the foot, which causes the plantar fascia to take an increased load which can irritate
Poor bio-mechanics can contribute to plantar fasciitis i.e. having flat feet or high archesWeight gain or excess weight can put extra load on the plantar fascia, irritating .
the tissues; this can also occur from the weight gain during pregnancy
Repetitive loading i.e. high level sports or working on your feet
Poor support from footwear i.e. worn or ill-fitting shoes
Arthritic foot joints can irritate the plantar fascia
Diabetic people have an increased chance of suffering from plantar fasciitis
Signs and Symptoms of Plantar Fasciitis
Pain at the base of the foot near the heel with weight-bearing
More pain after getting out of bed, or after prolonged sitting
Heel pain will be worse with the first few steps and will gradually improve as you move more
Generally your physiotherapist will be able to diagnose plantar fasciitis from your history, symptoms and a clinical examination.
Calf stretches often give relief to sufferers – it is important to stretch both calf muscles, so stretch with a straight leg and also a bent leg. Hold each stretch for 30 secs and repeat twice. Try to do this at least morning and night every day.
Freeze some water in an old water bottle and roll the bottom of your foot up and down on this.
Taping can offer you some relief while you are doing your exercises to off-load the plantar fascia.
Strengthening is an important component of treatment for plantar fasciitis as it improves the ability of the foot and ankle muscles to support the arch of your foot hence off-loading the plantar fascia.
Book an appointment with one of our physiotherapists who can help you with ideas for strengthening exercises to help ease the pain caused by plantar fasciitis.
Foot Pain OUCH!
You leap out of bed in the morning and you get stabbing pains in your heels or the arches of your feet. You hobble a few steps, and then hobble a few more until the pain reduces. Most of the day your feet feel OK …except when you tackle stairs or when you have been sitting for a while when the pain makes a reappearance.
Pain in your heel or the bottom of your foot is most commonly caused by Plantar Fasciitis. Your Plantar Fascia is the ligament that goes from the underneath of your heel to your toes. If you strain it, micro tears can form, which leads to swelling and sharp pain.
While most people experience the pain in their heel, some also get pain through to the arch of their foot. In about 70% of cases, the pain is in both feet, making walking a very painful experience.
You most commonly notice the pain first thing in the morning when you get out of bed and it reduces as your feet warm up with movement. It can reappear during the day after periods of rest or sitting, if you have been standing for a while, or when climbing stairs or ladders.
Plantar Fasciitis is more common in middle-aged people, although it can also affect younger people who use their feet a lot like joggers, dancers, or soldiers. That’s why it is also often called Joggers Heel.
Causes of Plantar Fasciitis
While the actual causes of plantar fasciitis are not known, there are risk factors that will increase the likelihood of you getting plantar fasciitis.
Overuse – excessive running, walking or dancing, or changing your training pattern so you dramatically increase hill running (for example).
Standing on hard surfaces
Flat feet or high foot arches (this is one time when average is better!)
Tight Achilles tendons or calf muscles
Your feet roll in when you walk or run
Ill-fitting shoes, worn out or unsupportive footwear such as thongs/slides
Walking barefoot on hard surfaces
First aid for Plantar Fasciitis
Generally, plantar fasciitis is gradual onset, which means it gradually increases in severity over time. If you ignore it and try to run through the pain, then the symptoms can get worse, ultimately leading to you changing your gait, limiting your activity or triggering the growth of heel spurs.
For initial symptoms, you need to rest, apply ice packs (15 minutes at a time every 2-3 hours), and take anti-inflammatory painkillers such as ibuprofen.
You don’t need a referral from a doctor to see a physiotherapist. If the pain is moderate then you can seek treatment with your Physiotherapist immediately as the sooner you begin treatment, the sooner you will experience relief.
Occasionally your plantar fascia can snap and you could hear a clicking or snapping sound, accompanied by swelling, intense pain and significant swelling. You need to see a doctor urgently if this occurs.
Physiotherapy & Treatment Options
Your physiotherapist will assess the extent of your injury, and will explore the causes of your injury.
Depending on your symptoms, you may have the soles of your feet taped or strapped to support your feet and reduce pain. You may also need to wear a plantar fasciitis brace or heel cups in the initial stages of healing.
Your physiotherapist will take you through a number of gentle stretching exercises for your feet, as well as exercises to address any tight Achilles tendons or calf muscles.
We will combine these with pain reduction techniques that you can do at home such as rolling your foot on a frozen water bottle or frozen golf ball to help ice your injury site.
Massage, joint mobilisation techniques, dry needling and ultrasound therapy will also be used to reduce swelling and restore movement.
For your footwear, we recommend you replace your joggers every 650km of use, and only wear shoes that support your feet while healing. Definitely no thongs or slides!
It also helps to put your shoes on first thing in the morning, before you take your first steps. Avoid barefoot walking on tiles or hard surfaces while you heal.
If the cause of your injury is your feet shape or foot pronation, you may need special orthotics. If this is indicated, we would conduct a walk/run assessment on you and have your technique analysed.
To maintain your fitness during your treatment, we recommend swimming and cycling. Don’t return to running until you have been pain free for at least one week, and then only run on soft surfaces until you rebuild your strength and stamina. If pain is felt at any time, then go back to swimming and cycling rather than running.
Unfortunately, Plantar Fasciitis is a long-term injury, and may take a number of months to fully heal even with the most aggressive treatments.
Things to Remember
Plantar Fasciitis is the most common cause of heel and arch pain, and is caused by micro tears to the plantar fascia.
It is a gradual onset injury and causes sharp pain when taking the first few steps in the morning or after rest.
Physiotherapy can treat plantar fasciitis, while reducing pain and increasing movement during healing.
Your physiotherapist may advise you of techniques for the improvement of your walk/running style, or provide you with solutions for arch support, to help prevent further reoccurrence.
Healing may take many months for full recovery.