What is sciatica?
Sciatica is a medical condition where we feel pain along the path of the sciatic nerve, in either of our legs and may (or may not) be accompanied by numbness, tingling and muscle weakness.
The sciatic nerve is the longest nerve in the human body. It starts in the lower back, goes down into the buttocks and continues behind each leg to the toes. Thus, the pain felt during sciatica can be in a different region of the leg, from person to person. For some, the sciatic nerve will provide pain in the buttock, calf pain, pain under the foot, while others will have their lower back pain all the way to the toes.
What causes sciatica?
Sciatica can be caused by other conditions in the back or leg, or by a direct injury to the nerve. However, very often we will find a progressive degenerative process which could have started with low back pain with right sciatica for example, and progress with an amplification of symptoms. Pregnancy is also another frequent source of sciatica since the body receives a new load in the region by the presence of the fetus and this changes the posture and the efforts in this lumbar region.
Why do you have a feeling of pinched sciatic nerve? At the level of the back, the nerve can be “pinched” or “stuck” by the narrowing of the space between the vertebrae (vertebral foramen) where the nerve exits to go to the leg. This space narrowing (stenosis) can be caused by osteoarthritis, a herniated disc, spondylolysthesis (slipping of the vertebra) or several other medical conditions.
In the leg, the nerve can be compressed by different structures. The most common of its conditions is piriformis syndrome where the nerve gets compressed by a muscle in the buttock, some describe it as gluteal sciatic nerve pain. Imagine your wallet in your back trouser pocket compressing the area (wallet syndrome).
The nerve can also be directly injured by compression, stretching or cutting. These injuries are usually of traumatic origin.
How to relieve sciatic nerve pain?
Physiotherapy is a good option to treat sciatica. During a first visit to the physiotherapy clinic, the physiotherapist will ask you questions about your condition and will perform a battery of tests that will aim to determine the cause of your sciatic pain and the various factors having an impact on your condition. He will establish a treatment plan with you based on your condition which may include posture correction, manual therapy maneuvers, sciatic nerve exercises, strengthening and/or stability exercises. He will provide you with advice on your lifestyle, how to minimize or manage your pain on a daily basis, how to adapt your activities while obtaining relief. He will guide you in your return to your usual activities, whether at work, in your leisure activities or in your sports activities. If, however, your condition requires a referral to another professional, whether it is a doctor for imaging tests, a medical intervention or a second opinion, the physiotherapist will be able to guide and support you in this process.
In some cases sciatica may require immediate medical consultation. If you experience any of these symptoms, please seek prompt medical attention:
You observe; tingling/numbness in both legs or in the genital area;
Loss of strength in both legs;
Appearance of incontinence (difficulty in retaining urine).
Advice while waiting to be seen by a healthcare professional:
Avoid prolonged positions that cause your pain, often the sitting position accentuates the pain.
Find the best positions that contribute to your relief and choose them when the pain is more present.
Applying ice for 15 minutes to painful areas can help reduce pain.
Breathing exercises, light flexibility and relaxation can help reduce the sensation of pain.
Avoid lifting heavy loads, forcing with the trunk misaligned or in rotation.