Physical Therapy for Sciatica
Is Sciatica a Pain in Your Butt?
There is no mistaking the pain of sciatica. Whether it’s shooting down the back of your leg or creeping up on you during a long car ride, you’ll quickly find yourself searching for a position or stretch to provide relief. As many as 40% of people will experience sciatica at some point in their lives which means at any given time there are many people looking not only for immediate relief but for long-term solutions. In this article we will discuss the common presentation of sciatica, its underlying causes and how physical therapy can treat this condition.
IS MY PAIN REALLY SCIATICA?
Sciatica refers to symptoms caused by irritation or compression of the sciatic nerve. When this nerve is irritated, symptoms will present themselves in the back of the thigh, leg and foot where the sciatic nerve and its branches provide motor and sensory input to the leg. A lot of people are familiar with the deep ache or shooting pain that can occur down the back of the thigh but these are not the only symptoms of sciatica. If you are experiencing any of the following symptoms, there is a good chance that sciatica may be the culprit:
Pain and/or pressure in the back, hip, leg(s), foot/feet
Throbbing, aching, shooting, sharp, dull, or burning pain in the buttock, back of the thigh, lower leg or foot
Numbness or tingling in the back, hip, leg, or foot
Weakness in the leg(s)
Inability to bend or rotate the back
Increased pain when coughing, sneezing, reaching, or sitting
Inability to stand up straight
Difficulty getting up from a chair due to pain or weakness
Inability to remain in one position for a long period of time, such as sitting or standing, due to pain
Pain that is worse in the morning
Limping when walking
The sciatic nerve is not the only nerve that can refer pain, numbness, tingling or weakness into the leg and a physical therapist can help localize the involved spinal nerves and segments based on the location of your symptoms. Identifying the origin of your symptoms will ensure that the treatment or exercises you do to address the problem are appropriate.
LET’S TAKE A LOOK AT SOME OF THE UNDERLYING CAUSES OF SCIATICA
Getting to the root of your symptoms is one important way that physical therapists can help facilitate long term resolution of your symptoms. A one-size-fits-all approach may provide some relief but is unlikely to take care of your problem entirely. In order to know how to treat these conditions we need to know what causes them. Here we will discuss some of the different causes of sciatica.
Let’s start with a review of basic spine anatomy. The sciatic nerve exits the spine through holes, or foramina, in the lumbar vertebrae of the low back. The sciatic nerve is a bundle of nerve roots from the last two lumbar segments (L4-L5) and upper sacral nerves (S1-S3). It travels down the back of the thigh splitting into smaller nerves that continue on down the lower leg and into the foot. It provides sensation and motor information to these areas and to the structures involved in bowel and bladder function. Sudden loss of bowel or bladder control can be a symptom of severe sacral nerve compression and is a medical emergency.
Sciatica, also called lumbar radiculopathy or “pinched nerve” can have many causes. A bulging or herniated disc, for example, can put pressure on the sciatic nerve roots as they exit the spinal column causing radiating symptoms into the legs. Similarly, bone spurs or arthritis that narrow the foraminal exit for these nerves may cause some irritation especially with certain movements or prolonged positioning. Acute injuries like a muscle strain can cause localized inflammation of tissue over the nerves causing compression and irritation. Finally poor posture or repeated movements may be a contributing factor to sciatica if biomechanics, strength and flexibility aren’t optimal.
WHY SHOULD I CHOOSE PHYSICAL THERAPY TO HELP ME WITH THIS CONDITION?
As you can see, there are many potential causes of sciatic pain. This is why it is so important to work with a skilled physical therapist if you have been unable to manage or fully eliminate these symptoms on your own. Through a careful interview and physical exam you will receive an individualized physical therapy treatment plan that will take into account your body’s unique presentation as well as the specific activities and exercises your daily life requires.
So, while no two treatment plans for sciatica will be exactly the same, these are some of the goals that will likely be a part of your plan of care:
Improve spinal mobility: Ensuring that proper flexibility and mobility exists in the entire spine is important to help balance stress and strain through the lower back. This can help reduce irritation or compression of the sciatic nerve roots.
Address mobility limitations in other areas of the body: While the pain may be originating in your spine, we can’t forget that the body is connected from head to toe. If you are lacking mobility or flexibility in the shoulders, hips, or ankles, for example, you may be overcompensating with your spine. Failure to address these areas may mean you continue to have extra stress through the lower lumbar spine.
Optimize spinal control: The spine was meant to move, but if it is not moved in a controlled manner, conditions like sciatica can develop. Learning to perform movements with the arms and legs while controlling the movement of the spine can not only improve your overall performance but also reduce symptoms of back pain or radiating pain.
Build strength and endurance to support the spine: Strength training of the abdominals, pelvic floor, hips and other areas is often an important tool in treating sciatica.
Learn to move better: If repetitive movements or poor posture are contributing to your sciatica symptoms then learning how to optimize your movements is an important step in facilitating long term results and minimizing the risk of symptom recurrence.
So, as you can see, a comprehensive treatment plan for sciatica is more than just performing a few stretches. This is why physical therapy is an excellent choice for treating sciatica. Let our team of therapists take the reins and help you achieve long-lasting relief of your sciatica symptoms.
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About EvolveNY-
Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better.
First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.
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