What is sciatic nerve pain?
It is a condition which results in a neurological irritation when the sciatic nerve is compressed in the lower back, pelvis or buttock. This often causes pain locally where the compression occurs and can refer pain down the back of the leg. There can also be other symptoms present such as pins and needles and weakness in the leg.
What causes it?
Sciatic nerve pain may be due to: sciatica or piriformis syndrome.
Sciatica is most commonly caused by a disc prolapse in the lower back which then puts pressure on the sciatic nerve exiting the spine. Evidence shows that 90% of sciatica cases is caused by a disc prolapse.
Piriformis syndrome is a condition where a muscle in your pelvis (piriformis muscle), becomes tight and presses on the sciatic nerve. This results in similar symptoms.
How do I know if I have sciatic pain?
Signs and symptoms vary depending on severity and how long you’ve had the condition. Typical signs and symptoms include:
- Pain in the buttock and/or back
- Shooting pain down the back of your leg
Other signs and symptoms may include:
- Muscle weakness in your leg
- Pins and needles or numbness down the back of the leg
- Pain when standing on the affected leg
- Difficulty sitting or walking due to pain
- Changes in your sensation in the leg
- Reflexes may also be affected
What can be done about it?
Your physiotherapist at Body Rhythm Physiotherapy will be able to conduct a thorough assessment to establish an accurate diagnosis for the cause of your condition and how best to manage it.
Treatment will vary depending on the cause of your pain but may typically include a combination of the following:
- Education about posture and posture correction/retraining
- Releasing trigger points and massage to reduce muscle tightness
- Dry needling which also helps to reduce muscle tightness
- Stretching to improve muscle length
- Joint mobilisation to improve movement
- Taping to correct your movement or offload the problem area
- Ergonomic advice to assist you in the management of your symptoms whilst continuing with your daily activities such as work
- Rehabilitation and strengthening programs to help you correct muscle imbalances and weakness
- Pilates and hydrotherapy classes – currently being offered throughout the week, run through our Beechboro clinic
Physiotherapy treatment is effective in over 80% of cases. Previously bed rest used to be prescribed but currently evidence shows that being active has more positive outcomes.
Physiotherapy management is progressed over 6-8 weeks and in the unlikely case that it doesn’t offer relief for sciatica, disc surgery may be considered but research shows that there is no difference between surgery and conservative management when symptoms were compared 2 years post.
Written by Body Rhythm Physiotherapist Kornelia Molenda.
Koes, B. W., van Tulder, M. W., & Peul, W. C. (2007). Diagnosis and treatment of sciatica. BMJ : British Medical Journal, 334(7607), 1313–1317. http://doi.org/10.1136/bmj.39223.428495.BE
Ji, M., Wang, X., Chen, M., Shen, Y., Zhang, X., & Yang, J. (2015). The efficacy of acupuncture for the treatment of sciatica: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2015.
Wheeler, A. H. (1995). Diagnosis and management of low back pain and sciatica. American family physician, 52(5), 1333-41.