How does physiotherapy help sciatica?

What is sciatica?

Sciatica is a common cause of pain and disability within the UK and has an estimated prevalence of up to 43% of the British population.  Sciatica can occur with and without low back pain and has a vast range of symptoms and presentation. Our Chartered Physiotherapist Rebecca Wyatt explores sciatica further.

Sciatica is a term which refers to pain, pins and needles, numbness or a combination of all three occurring in the lower limb.  Its name derives from the sciatic nerve, as the symptoms follow the pattern and distribution of the sciatic nerve from its origin in the spine and through the leg. The picture below shows the location of the sciatic nerve.

As you can see in this picture, symptoms can occur at any point along the sciatic nerve. Some people only experience buttock pain whereas others may experience pain or pins and needles in the foot. As well as pain, in some cases weakness can occur in the muscles which the sciatic nerve and its branches supply.  If this is the case you need to visit a Physiotherapist and see your GP.

What causes sciatica?

Most commonly the site of origin is within the lumbar spine (low back) and can be due to a herniated disc, a facet joint or the nerve root being impinged. In more extreme cases it could be due to a fracture, degenerative changes of the vertebrae (known as spondylosis and spondylolithesis) or narrowing or the spinal cord canal (spinal stenosis.) Other problems which can also lead to sciatic symptoms are:

  • Sacroiliac joint dysfunction
  • Piriformis muscle pain
  • Hip dysfunction or after hip surgery
  • During pregnancy.

A trip to your local Physiotherapist will include a thorough assessment of your symptoms and identification of the cause for you pain, ruling out any of the more serious conditions. A Physio will then be able to suggest an appropriate treatment plan and advise if any further investigations, such as an MRI, are necessary.

But my back doesn’t hurt?

Sciatica symptoms tend to refer away from the origin of pain, a process called peripheralisation.  As symptoms are addressed and treatment commenced, the typical pattern of healing involves the symptoms feeling like they are reducing back up the leg towards the centre of the back.  This is called centralisation and is perfectly normal. If you are visiting a Physiotherapist, this will be explained to you.

Treatment for sciatica

Treatment includes hands-on, manual techniques by a Physiotherapist as well as gentle, progressive exercises aimed at reducing pain and returning normal movement. You may be given gentle stretches for the sciatic nerve. Everything is judged on your symptoms, pain and tolerance levels. Towards the later stages of your treatment, exercises will be aimed at strengthening your low back and your core stability muscles. This is an important part of rehabilitation of sciatica as it can work towards preventing future recurrences.

If any of the above sounds familiar or if you suffer from sciatica on a regular basis, a trip to your local Physiotherapist may be beneficial. Here at Lilliput Health in Poole our Chartered Physiotherapists regularly see clients with a wide range of sciatica symptoms. Call our clinic today on 01202 725090 to find out more on how our team of experienced Physiotherapists can help.