Sciatica– Warner, Bray Park, Brendale & Cashmere

Integrate Physiotherapy provides quality Physiotherapy care for sciatica pain sufferers to the local areas ofWarner, Bray Park, Brendale & Cashmere.

If you have ever suffered from sciatica you will know how painful and disruptive it can be. Sciatica can stop you being able to do the most basic things such as walking, bending or sitting and severely interrupt your life.

In this blog we will look at:

 WHAT IS THE SCIATIC NERVE?

The sciatic nerve is the name of the longest nerve in your body. It is actually made up of two nerve roots that exit from the lower lumbar spine and three nerve roots that exit from the sacrum.

It travels from your low back out through your buttocks and down your thigh to your knee, calf, foot and toes. Your brain connects with the muscles in the lower leg and feet via the sciatic nerve, controlling muscle activity and sensation in your leg. It is vital for the control of your movement, sensation and balance.

WHAT IS SCIATICA?

Sciatica is actually the term that we use to describe any pain or symptoms, such as tingling or numbness that travel down the path of the sciatic nerve. Just like the word “headache” it is not an actual diagnosis of your problems, just an accurate description of the location of your pain.

Sciatic pain can be anything from a mild to severe ache or pain of such severe intensity simple tasks such as walking, bending, sitting or even just standing up can be difficult and in some cases impossible.

WHAT ARE THE TYPES OF SCIATICA?

There are two types of sciatica:

  1. Neurogenic
  2. Referred NEUROGENIC

In Neurogenic sciatica the pain is caused by compression of the sciatic nerve or smaller nerve roots that form it, symptoms can vary in severity due to the amount of pressure on the nerve.  This can be caused by a variety of problems, from bulging discs to tight muscles.

The discs between the vertebra can bulge, herniate or sequestrate (burst) causing direct pressure on the nerves leaving the spine. Pressure directly onto the spinal cord from within the spine can also compromise the function of the sciatic nerve. Tight muscles through the buttocks and top of the legs can also irritate and put pressure on the sciatic nerve.

In most of these cases the leg pain is worse than the back pain and described as a sharp, burning, shooting pain.  It is often associated with a feeling of numbness, pins and needles, hot and cold sensation and muscle weakness.

With neurogenic sciatica there are usually abnormal neurological exam findings such as a loss the normal reflexes, muscle weakness and sensory changes.

REFERRED

WHO IS AT RISK FOR SCIATICA?

It is estimated that over 40% of the population will experience sciatica at some time. The most common age for developing sciatica is between 40 to 50 years of age however it can affect any age group.

The major risk factors associated with sciatica are patients who have

  • Pre-existing spinal degeneration
  • Loss of normal spinal movement
  • A Sedentary Lifestyle
  • Employment involving in heavy work especially lifting
  • Diabetes

WHAT CAUSES SCIATICA?

  1. DISC BULGE OR HERNIATION

  1. The intervertebral disc is constructed of outer rings of cartilage inside of which there is a soft centre called the nucleus pulposus.When the disc bulges (prolapses) the nucleus polyposis has shifted with the disc however it remains contained within the outer cartilage rings. A bulging disc is very common in patients over 40 years of age.When the disc herniates (sequestration) this soft material escapes out of the disc through tears that occur in the outer fibers of the cartilage called annular tears. The nerve roots are extremely sensitive and the subsequent sciatic pain is caused by irritation of the spinal nerve roots, inflammation caused by proteins contained in disc material or a combination of both. They are caused by pre-existing weakness in the annulus or a sudden increase in pressure through the disc, poor posture over time damaging the discs, a sudden unexpected load or a motor vehicle accident
  1. SPINAL STENOSIS
  2. ABNORMAL SPINAL MOVEMENT
  3. SACROILIAC JOINT DYSFUNCTION
  4. PIRIFORMIS SYNDROME
  5. SPONDYLOLITHESIS
  6. PREGNANCY
  7. MUSCLE STRAIN
  8. TUMORS, FRACTURES, INFECTION
  9. ANKYLOSING SPONDYLITIS

WHAT ARE THE SYMPTOMS OF SCIATICA

The symptoms of Sciatica are usually a combination of

  • Sharp, shooting or searing pain in the leg
  • Numbness or pins and needles in leg and foot
  • Weakness when moving the leg or foot ,
  • Electric shock sensation in back or legs
  • Burning or prickling sensations
  • Inability to bring the foot upwards (walk on heels)
  • Weakness in lifting the big toe or ankle up
  • Pain and/or numbness on top of the foot, particularly between the big toe and second toe.
  • Pain and/or numbness to the lateral, or outside, of the foot;
  • Difficulty raising the heels off the ground

These symptoms will vary depending on many different factors, including the cause and location of the symptoms. While these symptoms can be severe and debilitating, it is rare that the sciatic nerve is permanently damaged.

The location of sciatic pain is:

  • Buttocks
  • back of the thigh
  • back and outside of the calf,
  • foot and toes.

The symptoms are usually only experienced in one leg but can occur in both.

With sciatica most patients will find that:

  • Pain that is worse when sitting or standing
  • Pain improves when lying down or walking
  • It difficult to stand up or walk normally
  • Pain is aggravated by sneezing or coughing

CAUDA EQUINA SYNDROME

Rarely people suffering sciatica can also experience a loss of bowel or bladder control or a progressive weakness or loss of sensation in their legs.  These are symptoms of a possible cauda equina syndrome. This condition is very serious and anyone experiencing these symptoms should contact their doctor urgently. If the nerve is compressed and the pain and symptoms are severe, surgery may be warranted.

HOW DO We TREAT SCIATICA?

At Integrate Physiotherapy our physiotherapists are well trained with latest evidence based practice methods and we will ensure you get the best possible care and management for sciatica.Many people who experience sciatica get better within a few weeks or months using a functional approach to treatment without surgery.

NONSURGICAL TREATMENT FOR SCIATICA

If you suffer from sciatica its most likely started from a functional, mechanical problem in your spine. The initial aim of your treatment is to remove the irritation of the nerve, reduce inflammation in the area and improve the movement in your spine.

It is important to stop you aggravating the problem further by avoiding activities such as bending, lifting and prolonged sitting. In severe cases you will need painkillers and anti-inflammatory medication to help control the symptoms while the cause is removed. Initially stretching exercises are also an important part of your treatment.The most important thing is that once your condition has stabilised your health care practitioner designs an individual treatment program and exercise regime to prevent recurrence.