What is it?
- Sciatic nerve pain also called Sciatica, originates in the lower back that radiates into the buttock and travels down the back of the leg, sometimes traveling below the knee.
- The sciatic nerve is the largest nerve in the body and originates from L4-S3 vertebrae.
- Sciatic nerve pain usually is only present on one side of the body.
- It is most likely to occur between the ages of 45-65 years.
- 2% of healthy populations and 5-10% of low back pain populations experience sciatic nerve pain.
What Causes it?
- A number of anatomical issues can cause sciatic nerve pain:
- Disc injuries placing pressure on the sciatic nerve as it leaves the spinal column
- Sciatic nerve irritation as it travels down the buttock into the leg.
- Tightness of the deep buttock muscles (Piriformis) as the sciatic nerve passes through it.
- Osteoarthritic changes on the spinal column that compress or irritate the sciatic nerve.
- A number of extrinsic factors can lead to sciatic nerve pain:
- Prolonged poor posture sitting
- Repetitive lifting with twisting
- Wearing high heels
What are the Symptoms?
- Sciatic nerve pain is generally reported as sharp, shooting or electric type pain starting in the buttock and travelling down the back of the leg in a narrow band.
- Low back pain is not always needed to have Sciatic nerve pain
- Can be aggravated by movements including; bending forward and sitting
- In severe cases it can be associated with numbness or pins and needles down the leg.
How does a Physio Diagnose it?
- First a thorough history is taken to rule out a serious pathology
- A physical exam is performed to identify the source of the symptoms with a neurological test involved.
- Imaging is only required if a serious pathology is suspected or after the failure of conservative management.
What is my Prognosis?
- Very good, most symptoms resolve with appropriate management in two-three weeks.
- In a small number of people, the pain can remain for a longer period.
How do you Treat it?
- A number of treatment techniques are used to treat sciatic nerve pain depending on the underlying cause. However firstly, the management of pain and inflammation is required.
- Physiotherapy treatment usually involves:
- Education and Advice
- Avoiding aggravating activities.
- Posture correction
- Spinal mobilisations
- Exercises and Stretches
- Soft Tissue Release
- Dry Needling