The sciatic nerve is the longest nerve in the body. The spinal sections it originates from include L4, L5 or S1.
Sciatica is commonly misdiagnosed, which can result is either slow or non-responsive treatment. The main nerve that travels from your lower back to your leg is your sciatic nerve. Irritation or pinching of your sciatic nerve can cause severe leg pain known as sciatica.
Pressure on the sciatic nerve from a herniated disc usually causes sciatica. Otherwise joint inflammation, compression of the nerve from bony arthritic growths or a locked facet joint in the lower spine can commonly cause sciatica.
Sciatica causes pain that usually begins in the lower back and spreads through the buttock, leg, calf and, occasionally, the foot. The pain can vary between dull, aching or burning sensations and sharp, shooting pains.
Sciatica can also cause tingling, numbness or muscle weakness in the affected leg. It is very important to seek medical attention in these situations as long-term nerve compression can permanently damage the nerve and its function. In these cases, your symptoms may become permanent.
One or more of the following sensations may occur because of Sciatica:
- Pain in the rear or leg that is worse when sitting
- Burning or tingling down the leg
- Weakness, numbness or difficulty moving the leg or foot
- A constant pain on one side of the rear calf
- A shooting pain that makes it difficult to stand up.
Sciatica is a clinical diagnosis based upon your symptom description, the behaviour of your pain and a thorough physical examination.
While the diagnosis of sciatica is reasonably simple, the primary cause of your sciatica may require further investigations to eliminate or confirm its origin.
It is also important to determine how significant your sciatic nerve has been compressed.
Your physiotherapist or doctor may send you for X-rays, or arrange for a CT scan or a MRI scan to check for problems in the spinal vertebrae (backbones) that may be irritating or compressing your sciatic nerve. Most cases of sciatica affect the L5 or S1 nerve roots.
1) Pain Relief and Protection
- Managing your pain –Pain is final symptom that you developed and should be the first symptom to improve.
- Managing your inflammation –Inflammation is a normal part of your healing process post-injury. Excessive inflammation can be the main cause of your sciatica.
2) Restoring Normal Flexibility, Posture & Strength
- As your pain and inflammation settles, restoring your normal back joint range of motion and lower limb muscle flexibility and posture is necessary.
- Exercise is prescribed to your needs following assessment of your muscle recruitment pattern
- Stability exercises may be required to increase your core strength
- Swimming and hydrotherapy exercises are beneficial in early injury repair due to lesser body-weight in the buoyancy of water.
3) Restoring Full Function & Dynamic Control
- The next stage of your rehabilitation is aimed at returning you to your desired activities
- Due to different demands, targets and goals, a physiotherapist is the best guide for your rehabilitation
4) Preventing a Recurrence
- Sciatica does have a tendency to return due to insufficient rehabilitation
- Fine tuning your back mobility and core control and learning self-management techniques will ultimately help you to achieve your goal