Sciatica refers to pain that radiates from a person’s lower back, into their buttocks, down their leg to their foot. It is caused by stress on the sciatic nerve, and affects 10% to 40% of the population. Typically, sciatica occurs most often when patients are in their 40s, and rarely occurs to patients before 20 years old. According to some studies sciatica could be genetic, but is shown to be more common in certain occupations that require individuals to be in physically awkward positions. The sciatic nerve is connected to the hamstrings, and lower extremity adductors, and is indirectly connected to the calf muscles, anterior lower leg muscles, and some foot muscles. People that receive non surgical treatment for sciatica will generally no longer have symptoms within 4 to 6 weeks. However, recovery may take longer. About 33% of people may have symptoms up to 1 year.
Typically, sciatica causes pain only along one side of the body. It usually is described as a sharp pain rather than a throbbing pain, and can be triggered when one coughs or sneezes, when one sits for long periods of time, or when one is standing up from a seated position. Individuals with sciatica also often experience numbness in their leg and foot. It may be that these individuals will have pain along one part of the sciatic nerve, and numbness in another.
Sciatica itself is not a diagnosis, but is a symptom that can be caused by a few different things. Most often, it is caused by a herniated disk in the spine that bulges and pinches the sciatic nerve. It could also be caused by an overgrowth of bone around the nerve. More rarely, it could be caused by a tumor that is compressing the nerve, or a disease such as diabetes that is damaging the nerve.
There are many things you can do to relieve pain, including medication and injections, but it is important to get to the root cause of sciatica in order to recover fully. Because there are many different causes of sciatica, there are several different treatments. Physical Therapy is often recommended for sciatica. After identifying the cause, Physical Therapists can help their patients return to a pain free and active life.
According to Andi Gross, DPT, Physical Therapists typically guide their patients with sciatica through hip and glute stretches, and perform manual therapy on the low back to increase spinal mobilization. Physical Therapists will also assist in strengthening the patients muscles to create space, stabilization, and increased core strength. Depending on the patient, Physical Therapists may also recommend light aerobic activities to encourage the flow of fluids and nutrients in the body. Other methods that Physical Therapists use to promote healing include cupping and dry needling. Cupping is a technique that uses suction cups to pull blood up to the surface of the skin, and allows the body to flush out toxins. Dry needling is a technique that uses very thin needles that are inserted into trigger points around areas of pain. It allows the body to recognize areas of stress, promotes healing and reduces pain. It is usually a good idea to stay active in order to maintain your pain. Doctors and Physical Therapists recommend following an exercise routine to strengthen muscle and bone strength, and increase the flexibility of the sciatic nerve. Keep in mind, it is important that individuals with sciatica consult a professional so that can make sure their posture and exercises are correct and will actually help them.