“Is it my sciatica?”
Have you heard someone at the office or party say, “Oh, I can’t do that because of my sciatica,” and wondered what sciatica is? The term is often misused to describe general low back pain. Even though sciatica is an umbrella term, it refers to a specific type of nerve pain that can involve the low back and the legs.
What is sciatica?
Sciatica is radiating nerve pain or numbness/tingling that runs down one or both legs. The pain may feel like burning, lancinating, or shooting down the leg, and can easily be traced with a finger because the pain follows the path of the sciatic nerve.
What causes sciatica?
Sciatic nerve pain is caused by compression somewhere along the sciatic nerve.
Where is the sciatic nerve?
The sciatic nerve begins in the lumbar spine (low back) and runs down the buttocks, back of the leg, and into the foot. There are two sciatic nerves in the body - one in the right leg, and one in the left. It is the largest nerve in the body.
What happens when a nerve gets compressed?
Nerves need three things to be healthy: blood, space, and movement. A nerve that has been compressed doesn’t have space to move well and has restricted blood flow. This can lead to pain, and even numbness and/or weakness in the muscles that the sciatic nerve powers. The sciatic nerve feeds the glutes (buttocks), hamstrings (back of the thigh) and indirectly, the calves (back of the lower leg). The nerves in the body are like an internal electrical system. When compression happens, the nerve signal can be affected, like lights being dimmed or even turned off completely.
How does the sciatic nerve get compressed?
Since the sciatic nerve is so long, several different structures could compress the nerve:
Disc - Disc herniation in the lumbar spine can press on the nerve root, sending pain down the leg. Symptoms are often worse with bending, lifting, twisting, or coughing.
Bone - A narrowing of the vertebral bones in the spine called spinal stenosis can press on a nerve root. Pain is often worse with standing, walking, or bending backwards. Pain may be relieved by flexing forward (bike riding, or leaning on a shopping cart).
Muscle - The piriformis muscle can get overworked with muscle imbalances. Another term for this is “piriformis syndrome,” and the pain often gets worse with lunges.
Other - There are many other structures that can compress the sciatic nerve. If you are having sciatic symptoms, it’s important to talk to your healthcare provider to rule out other causes.
Why does the root cause of sciatic nerve compression matter?
Sciatica is a symptom, not a definitive diagnosis. It literally means, “sciatic nerve pain,” but doesn’t tell us what is causing the pain. The goal of a PT’s evaluation is to consider the root cause by asking about your symptoms, reviewing your health history, and assessing your movement. This allows the therapist to collaborate with you in developing a treatment plan.
What does a physical therapy treatment plan look like for sciatica?
Research shows that combining manual therapy with exercise provides better outcomes than exercise alone. At Congruency, the therapist may use the following strategies:
Perform manual therapy, which involves hands-on mobilization of the spine, muscles, soft tissues, and nerves. The mobilizations will be different depending on which part of the nerve is being compressed and what movement limitations are present. Other treatment options include dry needling, cupping, Graston, therapeutic yoga or therapeutic Pilates.
Determine which positions are provocative and worth avoiding in the acute phase. As your symptoms improve, the therapist will help you expand your range of motion and positioning options.
Train more efficient movement patterns with core support so the problem doesn’t come back (no pun intended).
Educate on sleep position to prevent pain at night, and discuss at-home exercises to address muscle imbalances and improve posture.
If you have sciatica and are local to Charlotte and specifically the neighborhoods of Uptown, Midtown, Eastover, Myers Park, or Dilworth, reach out to our office in Midtown.
If you have sciatica and are located near Lake Norman and specifically near Cornelius, Davidson, or Huntersville please reach out to our Lake Norman Location.
