SCIATICA

 Sciatica is a nerve or nerve root pathology where the individual experiences pain or paresthesia caused by compression and/or irritation of the sciatic nerve or one of the associated nerve roots.

The sciatic nerve originates in the lower back (L4-L5 and S1-S3) where it branches out to both sides of the pelvis, via the gluteal region and down the back of the thigh (hamstring), down to the foot. 

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What causes sciatica?

Sciatica occurs when one of the above nerve roots gets compressed or impacted.  The most common causes of this include:

·      Herniated or bulging lumbar intervertebral disc

·      Muscle spasm

·       Spondylolisthesis – displacement of a vertebra

·      Spinal stenosis – narrowing of spinal canal within the vertebra. This leads to a decrease in space for the nerve to fit, causing compression of the nerve.

·      Priformis syndrome – whereby the piriformis muscle (located in the gluteal region), becomes inflamed. The inflammation can compress the sciatic nerve,

which passes under or sometimes, through the muscle.

·      Spinal Tumors – cancerous and/or benign tumors can compress the sciatic nerve.

 

Sciatica symptoms

·      Pain and/or deep ache in the lower back, buttocks, back of thigh or calf

·      Pain in the ankle or foot

·      Pins and needles or numbness

·      Loss of power through the leg

·      Hot and cold or tingling/ burning sensations in the legs


Sciatica Treatment & MYOTHERAPY

Below is a detailed general recovery treatment plan for an acute episode of sciatica

  1. Minimising Pain: Day 1 & 2- The first few days of experiencing sciatica can be debilitating and painful. For many, just getting in and out of bed can be an arduous task. In the first 1-2 days, minimal movement and avoiding activities that aggravate your back and gluteal areais wise. You may choose to take some anti-inflammatory medication (see your doctor for advice). Ice may be appropriate depending on muscle pain and location of this. Avoid ice around the spine.

  2. Increasing Range of Movement and blood flow to the area - After 48 hours it's a good idea to book an appointment with your myotherapist. They will assist you in gaining back some range of movement and helping to relax any muscle tension around the area. They will also be able to provide a thorough assessment to form a better understanding of what is going on. Remember - scans and imaging are NOT often required for low back pain.

  3. Getting back into your normal routine - One of the most important things I recommend those with sciatica to do is move! Evidence shows it is important to gradually get moving again and partake in your normal day-to-day activities, including lifting, twisting and bending, all of which help to strengthen and regain movement in the back. Avoiding doing such movements will mean a slower recovery. Best of all - walking works wonders for low back pain!