June 30, 2016
Sciatica refers to pain radiating into the leg from the low back. Pain can be at the back or front or side of the thigh and lower leg. It can be associated with pins and needles or numbness and muscle weakness. In most cases this occurs as a result of the pressure of a protruding lumbar disc onto a nerve root as it exits from the spinal cord close to the disc. Other causes may be obstruction of the nerve root by surrounding joint degenerative changes, or spondylolisthesis (movement forward of one vertebra relative to another vertebra).
The leg pain can be sharp or aching in nature and often quite severe, necessitating rest from activities that aggravate it – usually that includes forward bending, lifting weights or prolonged or poor sitting positions. Keeping relatively active but being guided by pain, is the best way to manage this condition.
Physiotherapy may be helpful in relieving pain initially and then in instituting a graded exercise programme. It is very important to learn to activate the core muscles as there will be weakness resulting from the back pain. These deep core muscles are responsible for supporting the spine as we move. Guidance is needed to be able to specifically isolate these muscles and your Physiotherapist will use real-time ultrasound for visual feedback to assist you.
Usually recovery from sciatica occurs within six weeks. Occasionally referral to a spinal specialist surgeon may be needed if pain is severe and if there is specific leg muscle weakness or bowel/bladder symptoms.
Early advice from your doctor and Physiotherapist will help you manage the condition and gain the best outcome.