Sciatica is one of the few medical terms that most of the general public understand and can relate to. Sciatica in its truest form is a sharp, lancinating pain that originates in the buttocks and can travel directly down the back of the leg to the ankle. The pain follows the course of the sciatic nerve, which starts in the buttock region and descends down the back of the thigh where it splits and continues further into the calf region and the ankle.
Now, the important thing to remember here is that in the vast majority of cases the nerve itself is not the original cause of the pain. The likely culprit will be in the region of the lower back, where the nerves exit the spinal column and begin their journey into the leg.
The next important thing to remember is that, despite the severity of the pain, in most cases there is nothing to worry about and the problem can be resolved with appropriate physiotherapy, medication, and self management.
Symptoms associated with sciatica can be
lower back pain
pins and needles
numbness in certain parts of the leg
weakness in the muscles of the foot or leg
Your doctor may prescribe strong painkillers to help reduce your pain, and in some cases prescribe medication that helps to reduce muscle spasm (diazepam), nerve pain (pregablin, amitriptyline), and inflammation (naproxen).
Whilst your pain may be severe, unless the doctor or physiotherapist suspects a serious problem, there is no need for a scan or X-ray initially. A scan or X-ray will not tell us anything we don't already know, and won't affect your treatment. If your symptoms persist or change, then it may be necessary to have a scan or similar later on.
Sciatica is one of the more common complaints we treat here at Delta, and treatment involve spinal mobilisations/manipulations, heat, massage, acupuncture, advice/education, home exercises and self management techniques. A good course of physiotherapy, combined with self management, will often have very good results.
You cannot be reliant on just having physiotherapy to alleviate your symptoms. You need to be doing appropriate regular self management which your therapist will be able to advise you on.
In very rare cases, there can be a medical emergency associated with lower back and leg pain; a condition called cauda equina syndrome. This occurs when the nerves responsible for control of the bladder and bowel, along with sexual function, are compressed, more often that not, by a disc herniation.
Symptoms of cauda equina syndrome are
loss of bladder and bowel control, i.e difficulty in urinating or defecating, or voiding bladder and bowel without trying to
loss of sexual function, i.e inability to maintain an erection
numbness in the saddle area, i.e buttocks, perineum, and inner thighs
If you were to experience any of these symptoms, you need to see a medical professional as a matter of urgency - Doctor, A&E etc. It must be stressed that this syndrome is quite rare, but awareness of it can help.
Contact Us for further information on how we can help with sciatica.
*The information on this page is not a substitute for medical advice and we advise people to seek help for any complaint from one of our physiotherapists or other suitably qualified clinician.