What is Sciatica?
Sciatica is a term used to describe pain in the sciatic nerve. This can run down the leg from the lower back, outside, or front of the leg. Often it is sudden following activities like heavy lifting, though gradual onset may also occur. Lower back pain is sometimes but not always present. Presenting symptoms include a sharp shooting leg pain, tingling, numbness or weakness.
What are the causes of sciatica
The are several causes of Sciatica. All of them are related to the same mechanism: the pressure on the sciatic nerve from a herniated disc, joint inflammation, bony arthritic growths (osteophytes).
The most common are:
lumbar bulging disc
facet joint injuries
Other causes less common are:
piriformis syndrome (nerve entrapment)
Central mechanisms: stroke, cerebral hemorrhage.
Management of such condition very much depends on the cause for the symptoms however, if sciatica results as part of spine degeneration or a lumbar disc injury then the following treatment methods can b considered:
– Deep tissue massage: focus on muscle relaxation, increased circulation, release of endorphins.
– Ultrasound: aiming to reduce inflammation in area causing the pain.
– Manual therapy
– A graded exercise programme aiming to reduce tension placed upon the nerve.
Adjuncts to physiotherapy
The conservative treatment is useful in most cases of sciatica. Corticosteroid injections can help to assist if pain is unremitting with an 80% success rate.
A combination of strengthening, stretching, and aerobic conditioning is a central component of the management of sciatica. If a patient is diligent in complying with a physiotherapy programme then pain can recover in a quicker time frame.
Exercise programme to consider
The following 8 exercises help stretch the sciatic nerve and other muscles; the combined movement may help expedite recovery.
Herniated Disc: Upper Back Extension is one the exercises prescribed by the physiotherapist
Spinal Stenosis: Flexion exercises of the lower back are suggested. Flexing the lower spine opens the spinal canal.
Degenerative Disc Disease: It is recommended for a dynamic lumbar stabilisation programme. The patient, with this technique, will find the most comfortable position for the lumbar spine and pelvis and will attempt to maintain this position during different activities. If is performed correctly, this exercise can improve the proprioception of the lumbar spine reducing the excess motion at the spinal segments.
Spondylolisthesis: It is very important for the spine stabilisation. Some examples of exercises are flexion-based exercises and stabilisation exercises.
Piriformis Syndrome: In this case, the aim is to decrease and improve range of motion with some exercises stretching the piriformis muscle, hamstring muscles, and hip extensor muscles
Sacroiliac Joint Dysfunction: In this case is very important to develop a programme for improving the range of motion exercises for the SI joint.