Sciatica pain affects a wide range of the population. The pain can show itself as numbness and be tingling in a leg, starting usually from low back or buttock area, going down to thigh, knee or all the way to the ankle, usually one side of body… unable to sit, stand or walk without pain. As a physical therapist, I meet at least two to four people a day who complains of sciatic pain – and they are not necessarily my patients, but my colleagues, my friends, relatives of my patients, my family members and a few of my readers. Sciatica affects young age, middle age, and old age people. And how can I forget wonderful pregnancy and Sciatica? So, today, let’s talk about what is Sciatic Pain and how physical therapy can help to treat it.
Definition:
The sciatic nerve is the longest spinal nerve. It starts from the lower back (Sacral plexus – L4 to S3) and runs all the way down behind the knee. There it divides into two branches. These branches ( called common Peroneal nerve and Tibial nerve) travel down to the foot. This is why symptoms of sciatica can run down to ankle or foot. Since this nerve travels so far, there are many places it can get compressed, or irritated causing painful symptoms. These symptoms are referred to as Sciatica or sciatic pain.
Causes of Sciatica Injury:
Sciatic pain can be positional, related to after-effects of surgery or any pathology in the spine or hip. Below are a few causes of Sciatic nerve irritation.
- Herniated Disc in Lumbar region
- Pregnancy – this is usually temporary. Sometimes uterus pushing down to hip in such an angle that can compress or irritates the nerve.
- Prolonged sitting
- Spinal stenosis at Lumbar region
- Hip replacement or arthroplasty
- Spinal tumor
- Exercising in a wrong posture/position.
- Trauma
I will discuss each cause in detail in my next blog.
Symptoms:
- Numbness and tingling in one buttock. Pain may travel down to thigh, knee or ankle
- Sudden sharp shooting pain while changing a position like standing up from sitting or starting to walk
- Localized Low back pain.
- Localized buttock or hip pain – usually deep buttock pain.
Treatment Approaches for Sciatica Pain:
There are a few ways to treat Sciatic nerve pain. The treatment approach also depends on the origin of the pain, severity, and cause of the pain. A physical therapist can relieve the pain if it is due to compression of the nerve. As mentioned above, the Sciatic nerve can get compressed between Lumbar discs level, or between two tendons of the piriformis muscle. You also want to seek PT’s advice if you think you are getting this pain due to exercising in a wrong posture. Gentle Yoga, hip stretches, nerve stretches, message, and aerobic exercises can help relieve the symptoms. Heating modalities can also help reduce pain. Avoiding sitting for long stretches and moving position frequently are proven to reduce the symptoms.
It is a good idea to talk with your primary doctor if you are suffering from Sciatic nerve pain. Your doctor can recommend some anti-inflammatory and muscle relaxants.
Prevention:
Proper posture and regular exercises to strengthen back, and hip muscles keep this long nerve happy in its place. If you have gone through any spine or hip surgery, it is important that you follow through post-surgery exercise recommendation. Regular stretches are important as it keeps muscles and tendons in a lengthened position. This gives enough room for this longest nerve in its home!!
Conclusion:
Sciatic pain is very common. It can be severe and recurring. If not treated effectively, it can affect a person’s psychological state. My aim through this blog is to spread general awareness about this widely known painful pathology and to provide some treatment approaches. If you have any questions please free to contact me. Hope this helps!