Sciatica is a common condition that causes pain, numbness, and tingling in the buttocks and leg. The pain is caused by irritation of the sciatic nerve, which is the largest nerve in the body. The sciatic nerve runs from the lower back down through the buttocks and leg to the foot.

Causes of Sciatica

There are several causes of sciatica, but the most common are:

• Herniated disc. A herniated disc occurs when the soft, inner part of a disc between the vertebrae in the spine leaks out. This can put pressure on the sciatic nerve.

• Spinal stenosis. Spinal stenosis is a narrowing of the spaces in the spine. This is more common as you become older. This can also put pressure on the sciatic nerve.

• Piriformis syndrome. Piriformis syndrome is a condition in which the piriformis muscle, which is located in the buttocks, compresses or encroaches upon the sciatic nerve.

• Spondylolisthesis. Spondylolisthesis is a condition in which a vertebra slips out of place. This can put pressure on the sciatic nerve.

Other Causes of Sciatica

In some rare cases, sciatica can be caused by other conditions, such as:

• Tumor. A tumor in the spine can put pressure on the sciatic nerve.

• Fracture. A fracture in the spine can also put pressure on the sciatic nerve.

• Infection. An infection in the spine can irritate the sciatic nerve.

Symptoms of Sciatica

The most common symptom of sciatica is pain that radiates down the buttocks and leg. The pain may be sharp, burning, or tingling. Other symptoms of sciatica may include:

• Numbness.

• Tingling.

• Weakness.

• Difficulty moving the leg.

• Foot drop (difficulties lifting the foot off the ground when walking, causing the foot to scrape along the ground)

• Changes of gait

Diagnosing Sciatica

To diagnose sciatica, your clinician will ask about your medical history and symptoms. They will also perform a physical examination. A good clinician should be able to differentiate between sciatic nerve pain, hip pain, hamstring strain, or other related pathologies. If working with an MD or DO, they may order tests, such as an X-ray, MRI, or CT scan, to rule out other possible causes of your pain.

Treatment for Sciatica

The treatment for sciatica depends on the underlying cause. In most cases, sciatica can be treated with non-surgical treatments, such as:

• Rest.

• Ice or heat therapy.

• Over-the-counter pain relievers.

• Muscle relaxants.

• Physical therapy.

• Injections.

In some rarer cases, surgery may be necessary to relieve the pressure on the sciatic nerve.

How Physical Therapy Can Help with Sciatica

1. Receiving a proper diagnosis - receiving the correct assessment is essential for creating the right plan for treatment. It’s important that your therapist rules in/out other related pathologies

2. Overview of overall musculoskeletal system - Often times, sciatica does not exist in isolation. Oftentimes, the lower back can be compensating for range of motion restricitions in the hips or upper back. Having a thororough assessment of your body is important for helping to prevent future flare-ups.

3. Receiving manual therapy and/or joint manipulations - Receiving evidence based manual therapy techniques can be incredibly helpful to relieve acute pain and improve your ability to perform daily activities with less pain

4. Improve strength - A good physical therapy plan should include a progression of exercise/movement routine to help build up strength and mobility in the spine as well as the general body so that you can return to doing the things you love.

Conclusion

Sciatica can be a painful condition, but it is usually treatable. If you are experiencing symptoms of sciatica, see your doctor or a trusted clinician to properly diagnose and treat the underlying causes. Physical therapists are experienced in diagnosing and treating various causes of sciatica.

Additional Tips

• If you are experiencing sciatica pain, it is important to avoid activities that aggravate your pain.

• You should also avoid prolonged sitting or standing.

• If you must sit for long periods of time, make sure to get up and move around every 30 minutes.