Sciatica is pain and tingling that is felt down the leg that results from irritation of the sciatic nerve. The pain of sciatica is typically felt from the low back, through and deep to the, to behind the thigh and can radiate down below the knee. Often altered sensation or pins and needles can be felt in the calf or foot. The sciatic nerve is the largest nerve in the body and begins from nerve roots that exit from the lower back and extend through the buttock area to send nerve endings down the lower limb.
Sciatica results from generally presents from 2 difference factors - 1) age-related degenerative changes leads to a narrowing of the exciting hole that the nerve comes out the spine from, often causing pinching of the nerve and ongoing pinching can lead to compression and this can then lead to irritation and consequently inflammation. And 2) direct disc prolapse or herniation, which presses into the nerve. Any cause of irritation or inflammation of the sciatic nerve can produce the symptoms of sciatica.
- Herniated disc
- Degenerative disc disease
- Spondylolisthesis (slippage)
- Spinal stenosis (canal narrowing)
- Piriformis syndrome
- Sacroiliac (SI) joint dysfunction
More sinister causes:
- Spinal tumour
- Inflammatory arthritis
Constant pain in only one side of the buttock or leg (rarely in both legs)
Pain that is worse when sitting
Leg pain that is often described as burning, tingling, or a dull ache
Weakness, numbness, or difficulty moving the leg, foot, and/or toes
A sharp pain that may make it difficult to stand up or walk
Pain that radiates down the leg and possibly into the foot and toes (it rarely occurs only in the foot)
Nerve root pain is pain that occurs because a nerve coming from the spinal cord is pressed on (trapped) by a 'slipped' (prolapsed) disc, or is irritated by the inflammation caused by the prolapsed disc.
If the following are experienced, this is a medical emergency.
Problems with bowel and bladder function (usually inability to pass urine).
Numbness in the saddle area around the back passage (anus).
Weakness in one or both legs.
Most disc prolapses that causes sciatica will often heal over a period of time with the correct treatment and advice. Conservative treatment is often sufficient for healing of most cases of disc injuries. However, if patient experiences a very bad disc prolapse and severe pain is felt, treatment may be longer established. Surgery is rarely needed and an absolute last resort of exhausting all other methods. Less than 3% of our patients here at Dynamic Osteopaths are referred for spinal surgery for disc tears.
- The goal of conservative treatment is to provide pain relief, restore functional mobility as soon as possible with the long term goal of working preventaitive of reoccurrence of disc herniation.
- Sciatica and disc injuries are relative to neck also, however, the sciatica nerve is not involved this this case. It can be another nerve causing what is known as radiculopathy.
- Conservative treatment sometimes includes pain medications or NSAIDs like ibuprofen, naproxen alongside osteopathic treatment and physical therapy. Also, preventative exercise.
- Manual therapy (osteopathy), physical therapy and acupuncture.
Exercises For Sciatica
It is important to stay 'relatively' active alongside appropriate rest for healing of a disc prolapse. Discs respond to movement. This being said, it is very important to establish the extent of the damage caused initially. Dependant on the extent of the injury, will determine how much you can do to start with.
Only if advised to do so, it is important to do some low impact exercises under the guidance of your osteopath, such as:
Lying knee hugs (single)
Gentle active mobility exercise, with gradual progression
General Exercises For Sciatica
Sciatica exercises should focus on three key areas:
3) aerobic conditioning
Dynamic core conditioning can provide pain relief because it will support the spine, keeping it in alignment and facilitating movements that extend or twist the spine with less chance of injury or damage.
Further specific exercises (below) can be adopted when tolerated
PLEASE FOLLOW LINK HERE FOR SPECIFIC SPINAL REHABILITATION FOR DISC INJURY