Sciatica is a condition that affects millions of people worldwide and is estimated that around 40% of the population will experience it at some point. It is a painful condition that can range from mild to severe, and in some rarer and more severe cases requires surgery. While the condition can affect people of all ages, it is most commonly seen in adults between 30 – 50.
In this blog post, we will discuss what sciatica is, the most common causes, typical presentation, and the steps you can take to help yourself if you’re suffering from sciatica.
What is Sciatica?
Sciatica is a condition characterised by pain caused by irritation or compression of the sciatic nerve. The sciatic nerve (which is the largest in the human body) runs from the lower back to the legs and if compressed or irritated it can cause a pain that can be severe and may feel like a burning, shooting, or electric shock sensation. In some cases, the pain may be accompanied by numbness, tingling, or weakness in the legs. The presentation of sciatica can vary from person to person.
Most Common Presentation & Causes of Sciatica
As mentioned above, symptoms can vary from mild to severe, and can be described as anything from sharp stabbing or electrical pain to more of a dull ache. Pain typically starts in the low back, spreads into the buttock and into the back of the thigh (hamstring area) and can sometimes spread lower into the calf and even the foot.
Depending on the severity it can also cause changes in the muscle function, such as weakness and a feeling of difficulty with certain movements such as going onto your tip toes.
What Causes Sciatica?
Although often described as a diagnosis, sciatica itself should not be used as a diagnosis but rather a symptom of a separate diagnosis. Sciatica will not just start because the nerve feels like it, the nerve itself has to be irritated or compressed by something else in order to do so.
As Chiropractors we always aim to find the root cause of any problem, and fortunately for us there are several assessments, orthopaedic and neurological tests that help us come to the conclusion of what we believe is likely to be causing your sciatic pain. Here are the most common causes:
- Lumbar Disc Injury – this can range from a small bulge to a complete herniation of one of the intervertebral discs in your lower spine. The disc itself sits in between each vertebrae and if injured or inflamed it can cause pressure and irritation of the nerve root in the low back; causing sciatic pain to radiate into the leg where the nerve travels.
- Degenerative Changes – as we age our joints naturally start to wear. This can result in reduced disc height and we can get small bone spurs developing. If this happens in the low back they can encroach on the space where the nerve passes through and cause issues.
- Muscular Issue – The Piriformis – there is a muscle that sits deep in the buttock called the piriformis. The sciatic nerve can be irritated as it passes between this muscle and the bony point at the bottom of the pelvis called the ischial tuberosity. This happens if this muscle is tight, inflamed or in some cases if anatomically the nerve sits closer to the muscle than it does in most people.
There are also other, less common causes too and this is why it’s always important to get a thorough assessment. Depending on the suspected cause your prognosis and time of recovery will vary. In some cases a referral for imaging, such as an MRI scan may be warranted.
7 Steps You Can Do to Help Yourself:
- Keep Moving – while it may sometimes seem counterintuitive it’s almost always beneficial to keep mobile where possible. Avoiding activity altogether is definitely not the right way to manage sciatica.
- Avoid Obvious Triggers – while the above is true and important to keep moving, it’s also important to avoid obvious triggers initially in your healing journey, especially if sciatica is new and acutely painful.
- Do Your Rehab – It’s extremely important with sciatica to keep consistent with your rehab exercises. Little and often is the key here; spending 2 minutes a day 3-5 x throughout the day is more beneficial that 1 x 10-15 minute session. Initially we want to increase the exercises that help (such as nerve flossing exercises) and avoid certain triggers in the acute phase. Then once you start to feel better start to reintroduce these triggers back into your daily life to increase your tolerance to them.
- Hot & Cold Therapy – heat/cold can help to soothe the pain associated with sciatica. We recommended 10-20 minutes of heat followed by cold.
- Manage Your Sleep Position – try laying on the unaffected side and placing a cushion between your knees when you sleep, or try laying on your back with your feet elevated slightly on a cushion.
- Practise Mindfulness – try meditation, deep breathing, and visualisation techniques to help reduce stress and promote relaxation.
- Get Help – Visiting a chiropractor can help get to the underlying cause of the sciatica and provide specific and tailored treatment to help ease your symptoms. Then with time a rehab therapist can help to build strength to increase tolerance and help avoid flare ups in the future.
As always, if there is anything our therapists at SYNERGY can do to help you or answer any questions you have then feel free to get in touch, we’d love to help you.
