Sciatica is a catch-all term that simply indicates that a patient has pain down the back of their leg and truly does not indicate a diagnosis or cause for the pain.
Common causes of sciatica include:
- Disc bulge or herniation, which is at the L4 or L5 disc causing inflammation, puts pressure on the nerve root and causes pain to radiate into the buttock, back of thigh and or leg.
- Piriformis syndrome, which is tightness of the hip muscles in the buttock that is responsible for turning your hip out which causes it to become tight and put pressure on the sciatic nerve that runs underneath the piriformis muscle.
- Degenerative Disc Disease, which is in the lumbar spine which causes narrowing of the spinal canal and causes irritation of the nerves that make up the sciatic nerve.
- Facet arthrosis, in the lumbar spine, which is a narrowing of the hole as the spinal nerve roots exit the spine and causes compression of the nerves that make up the sciatic nerve.
- Spinal tumor, which can put pressure on the nerve roots.
It is extremely important to get assessed as each condition requires very specific treatment and exercises to help alleviate and rehabilitate the pain from the sciatica. In order for your doctor, chiropractor or physiotherapist to arrive at an accurate diagnosis, make a note of the following:
- Was there a history of trauma?
- Is your sciatica relieved or aggravated with bending forward?
- Is your sciatica relieved or aggravated with bending extension?
- Is your sciatica relieved or aggravated with sitting?
- Is your sciatica aggravated with coughing or sneezing?
- Do you have any loss of sensation or weakness in your leg?
- Do anti-inflammatories help you with your pain?
Sciatica is a medical emergency if you have any of the following signs or symptoms:
- Bowel or bladder incontinence.
- Saddle parasthesia – which is numbness around your groin.
- Unexplained weight loss.
- Pain that constantly wakes you up at night and is not relieved with lying down.
- Unexplained fever with back pain.
- Swelling and redness along the spine.
- The pain is getting worse and is sever.
- You have had the pain for 4 weeks or longer that is not responding to treatment.
Sciatica treatment can consist of any one or more of the following:
- Manual therapy to help assist with healing of the nerve roots where there is irritation from the tissues, and increase spinal motion of joint dysfunction.
- Exercise in positions that alleviate the pain and general exercise to increase core stability and muscular endurance and strength.
- Ice and heat to help with controlling pain and inflammation.
- Acupuncture to decrease pain and inflammation.
- Modalities such as TENS (trans electrical nerve stimulation), laser, or muscle stimulation, to alleviate pain.
- Anti-inflammatories and/or pain medication prescribed by a physician.
- Traction to assist in decrease nerve root pressure.