Sciatica is the generic term used to describe an irritation down the Sciatic nerve. Sciatica itself is not a condition, rather a symptom, so it is important to understand the anatomy of the nerve of what the cause is to effectively treat it. Commonly thought as a lower back problem it should not be confused with generic lower back pain. Sciatic symptoms include numbness or tingling through the buttocks and down the posterior leg, pins and needles in the feet and toes, often lower back pain is less painful or irritating that the numbness and tingling sensations felt in buttocks and legs.
The Sciatic nerve is the longest and widest nerve in the body, it forms from L4 to S3 regions of the Sacral spine and merges into one just before the piriformis muscles located across the buttocks (Fig A and Fig B). The nerve runs from the top of the leg, all the way down the posterior aspect into the foot. The sciatic nerve supplies motor and sensory functions to the lower body.
Warning Signs and Sciatic symptoms
Numbness and tingling down the posterior leg
Lower back pain A dull ache in the buttock
Pain in the back of the leg, often worse when siting
Weakness or loss of function of one leg
A shooting pain when standing up
Hip pain
What Causes Sciatica?
This is important to establish as Sciatica is the result of a number of different causes, these can range from disc/vertebra issue to muscle tension in the Gluteals.
Lumbar Spinal Stenosis (narrowing of the spinal canal in the lower back)
Disc Degeneration (breakdown of disc which act as cushions between the vertebrae)
Inflamed or tight muscles around the spinal cord
Bulging disc
Herniated disc
Muscle spasm in the back and Buttocks
Inflamed or tight muscles around the spinal cord
Excessive Lordosis (increased curvature of the lumbar spine)
How do we treat Sciatic symptoms at Pentons Performance Therapy?
A full consultation and assessment will take place to ensure we understand the cause of severity of the Sciatica. Once this is established, we can begin to work on the effected area. We are seeing a rise in the number of cases of sciatica being caused by bulging discs as a result of excessive lordosis due to poor posture or being seated for long periods of time. This often means muscles of the hips, posterior leg and lower back become very tight. We use deep massage techniques combined with hot stones to allow for pain free movement initially and then can begin with mobilisation and manual therapy work to free up the irritation on the sciatic nerve.
In extreme cases such as herniated or bulging discs we can run through more in depth mobilisation work and manual therapy to encourage the healing of the disc whereby the fluid is returned to the centre and no longer compresses the Sciatic nerve. We will perform the physical therapy assisted in the clinic but will also give out detailed aftercare advice and activity so you can continue recovery whilst away from the clinic as well.
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