According to the Australian Institute of Health and Welfare, sciatica is one of the three main reasons why back pain is affecting approximately 4 million people per year.[1] Within a lifetime, it is expected that 49-70% of people will experience sciatica.[2]
Many people with sciatica will not even know they are experiencing it. Due to the location of the pain from sciatica, many people can confuse sciatica as a calf or hamstring strain.
Read on to understand what you should know about sciatica; the risk factors, treatment options and expected recovery time.
What is Sciatica?
Sciatica describes discomfort (e.g. pain, tingling) arising from irritation of the sciatic nerve, especially down one or both legs. Compression on the sciatic nerve is a usual reason for sciatica. Usual culprits include bulging discs from the back and tight hip muscles.
What are the symptoms of sciatica?
The symptoms of sciatica include pain in the lower back that can radiate down the buttocks and legs. People may also experience numbness or pins and needles, as well as increased pain with movement, particularly when bending forward or flexing the back.
Common symptoms of sciatica
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Pain that gets worse during movements
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Numbness and weakness of the legs and feet
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Loss of sensation on the legs
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Sometimes causes an inability to control bladder or bowels
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Muscle spasm of the lower back or buttocks
What causes sciatica?
Sciatica occurs when the sciatic nerve originating from the lower part of the spine is irritated, compressed, pinched or inflamed. A bulging disc usually causes sciatica, however other lower back problems like spinal stenosis, spondylolisthesis and osteoarthritis can also cause sciatica.
Common reasons why people experience sciatica
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Improper lifting techniques
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Injury to the lower back
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Falling on your back or buttocks
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Spinal conditions
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Repeated bending of your back.
Common injuries that cause sciatica
Herniated disc
Disc herniation can put pressure on the nerve roots of the spine. This usually happens when there is a sudden bending of the back while lifting a heavy load.
Spinal stenosis
Abnormal narrowing of the spinal canal can compress and irritate the spinal cord and nerve roots.
Spondylolisthesis
This condition causes the lower bones of the spine to slip forward directly on the vertebra beneath it. This causes impingement on the sciatic nerve roots.
Piriformis Syndrome
This involves problems with the piriformis muscle of your lower back and buttocks causing increased pressure on the sciatic nerve.
Sports that increase the risk of sciatica
High-intensity sports that require repetitive bending, lifting and twisting put people at high risk for injuring the spine resulting in sciatica.
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Weight lifting
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Football
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Bowling
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Baseball
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Tennis
How is sciatica diagnosed?
There are several options available when it comes to diagnosing your back pain as sciatica. One of the more common and most recommended by Australian GPs is an assessment from a physiotherapist.
Physiotherapists are experts in spinal rehabilitation. They are medically qualified to diagnose and treat sciatic pain and other spinal conditions to manage your pain and get you back on your feet as soon as possible.
Your visit will start with a simple consultation. Your physiotherapist will ask vital questions regarding your back pain as well as your general health and lifestyle. Use this time to discuss all your symptoms and issues related to your spine and lower back.
After establishing the background of your condition, your physiotherapist will then perform a detailed assessment of your spine and muscles to determine the root cause of your sciatica.
Your physiotherapist will then create a diagnosis and treatment plan based on your assessment. This whole process will take about 30 to 60 minutes.
You will also be given the details of your program. This will include:
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Number of treatment sessions
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List of exercises you need to do at home
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Strategies to manage the pain and prevent complications
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Timeline of your recovery
How is sciatica treated?
Sciatica is usually a symptom of an underlying condition that you need to address. Medication can help you deal with pain, but only physical intervention can correct spinal impairments.
There are several options when it comes to treating sciatica. One of the more common and the treatment option referred to by Australian GPs the most frequently is physiotherapy.
Sciatica is a condition that physiotherapists come across regularly and the process of treating it is straightforward.
Following an initial consultation, the physiotherapist will be in the best position to determine your treatment plan.
Your treatment will focus on reducing your pain, improving your mobility and stabilising your spine. Your physiotherapist will prescribe corrective exercises to improve your condition.
Depending on the severity and the cause of your sciatica, a physiotherapist may provide you with a combination of the following types of treatments:
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Mobility Exercises - Involves techniques to increase your range of motion and decrease joint stiffness.
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Soft tissue Mobilisation - Used to stimulate muscle relaxation and improve blood circulation in the area.
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Therapeutic Exercises - Includes exercise techniques to help you correct your body mechanics and improve overall function.
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Core stabilisation exercises - Used to improve core and spinal muscle strength to provide better stability on the spine.
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Joint Mobilisation/Manipulation - Hands-on techniques designed to improve pain and decrease symptoms.
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Dry Needling - Specialised technique is used to relieve pain and reduce muscle spasms.
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Advice and Education - Expert advice on how you can manage the pain and gradually return to your activities.
Physiotherapy treatment can last for about 30 to 60 minutes. Most patients can feel the difference in just a single session.
Next step - Creating a treatment plan made for you
After your initial evaluation, your therapist will create a detailed treatment plan based on your condition and goals to maximise your recovery.
Self-care for sciatica
If you have sciatica, here are the best things you can do and avoid.
Things to do:
Irritation of the sciatic nerve may cause local inflammation in your spine resulting in various symptoms you are experiencing.
Resting for a couple of days can help your body recover and decrease the spinal nerves’ irritation. Drink lots of water to support your recovery.
Applying a hot compress for about 15 to 20 minutes can decrease the muscle spasm in your back and improve your pain.
Specific gentle stretching exercises and positions can reduce the pressure on the sciatic nerve. Your physiotherapist will teach you proper stretching techniques that you can incorporate into your daily exercises.
Light massage can help you relax. It can reduce muscle spasms and improve blood circulation in the lower back area.
Staying active as much as possible is the key to treating sciatica and preventing complications due to inactivity. Walking is an effective treatment to keep your body active while reducing your pain and inflammation.
Things to avoid:
- Avoid lifting heavy objects
Avoid engaging in activities that will place a lot of stress on your spine.
Repetitive bending motion can increase the pressure on your spine and puts you at risk of developing disc herniation resulting in sciatica.
Do I need a specialist or surgery?
Sciatica rarely requires surgical intervention. In the case of severe disc herniation, surgery may be performed to alleviate pressure on the nerve in the spine.
Before considering surgery, diagnostic imaging should be undertaken to assess whether or not a patient would be appropriate.
The best course of action would be to consult with your local GP or physiotherapist to determine whether or not it would be appropriate.
What is the recovery time / prognosis for sciatica?
Ultimately, recovery time is dependent on being proactive and seeking professional treatment and the severity of your back pain and injury.
Patients who experience sciatica usually recover within 4 to 6 weeks, however some cases can last longer.
Physiotherapy can significantly improve the treatment outcome for sciatica and help patients recover faster while also improving their overall function.
Important factors in recovery include:
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Age
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Severity of injury
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Sticking to your rehabilitation program and regularly exercising
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Resuming your sports activity gradually
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Paying attention to pain, and resting as necessary
Can sciatica be prevented?
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Strengthen your core muscles: Strengthening your back’s core muscles and spinal muscles can prevent lower back injuries and decrease your risk of developing sciatica.
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Use proper lifting techniques: Proper lifting techniques can help. Lifting with your lower body instead of taking too much pressure on your lower back can decrease your risk of injuring your lower back. When lifting an object, always bend your knees and use your lower body strength to lift the object.
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Maintain good posture: A good posture can help relieve tension in your lower back muscles.
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Stretching: Stretching can help your muscles maintain their flexibility and nerve irritation. Stretching your piriformis muscles, hamstrings, glutes and lower back is an excellent way to include them in your routine.
Outlook and the main takeaways
Sciatica is a painful condition resulting from spinal injury or nerve impingement. It can limit your mobility and affect the quality of your life.
It is essential to not ignore symptoms of sciatica to prevent further complications.
Book a time to have your condition assessed by a physiotherapist and start your recovery as soon as possible.
Anatomy of the spine
There are pairs of nerve roots that exit your spinal vertebra on each side to provide sensation and motor control (movement) to your lower back down to your legs.
The sciatic nerve comprises five nerve roots from the lumbar region (lower back) and sacral segments (buttocks) of your spine. These nerve roots come together to form the sciatic nerve, which runs down through the buttocks, hips, and legs.
The sciatic nerve also branches down to the foot and toes.
Injury to the spine or spinal disc can irritate and impinge the sciatic nerve, which causes pain that radiates to the distributions of the sciatic nerve.
Affecting the sciatic nerve causes movement problems and sensation issues along the lower back down to the foot and toes.
