Sciatica                            

Sciatica is a term that is used to describe leg pain that radiates from the low back area, although the actual cause of this can vary. 

A ‘true’ sciatica occurs when one of the spinal discs (the squashy pads between the bones of the spine) bulges and puts pressure on the sciatic nerve as it leaves the spine to travel down the leg. The symptoms can include pain, pins & needles, tingling and numbness all the way to the foot. In some circumstances a feeling of weakness can be felt if the disc bulge presses on the part of the nerve that supplies the muscles of the leg. The symptoms are usually on one side only and mainly affect people under the age of 50, although by no means exclusively.

Other causes of ‘sciatica’ can include degenerative (wear and tear) changes in the spine. The sciatic nerve exits the spine through a hole called a foramen and this hole can narrow as the joints and discs show signs of wear. This can then restrict the movement of the nerve giving ‘referred’ symptoms into the leg.

Another common cause of sciatica occurs with a tightening of one of the deep buttock muscles. Although there are several of these muscles, one of them, called Piriformis, is prone to tightening often as a secondary response to a problem elsewhere such as low back or hip pain. The Piriformis muscle sits on top of the sciatic nerve as it runs through the pelvis in the buttock and any tightening of the muscle can lead to pressure on the sciatic nerve leading to leg symptoms.

The treatment and management of sciatica, of course, will depend on what is causing the symptoms in the first place, be it a disc bulge, foramen narrowing, Piriformis tightening or other factors. However, in the vast majority of cases the condition is very treatable and often will involve some hands-on Physiotherapy to help restore normal joint, muscle and nerve movement. The teaching of self-management techniques and the giving simple, relevant exercises to follow at home are equally important. Treatment should also address the inflammation that invariably accompanies sciatica.

There is no ‘one glove fits all’ approach to the treatment of sciatica but careful assessment of the factors involved and relevant treatment will normally lead to a better and quicker recovery and a return to normal daily activities.