Sciatica is a term commonly used to describe pain, weakness, tingling, or numbness radiating down the back of the leg. As one of the most common conditions treated in physical therapy, sciatica is produced by an irritation of the nerve roots leading to the sciatic nerve. The pain usually begins in the back or buttocks and follows the distribution of the sciatic nerve, through the back of the legs. The pain symptoms are quite unpleasant and can disrupt your normal daily functions if sciatica treatment is not sought out. When seeking sciatica pain relief or sciatica treatment, it’s important to first pinpoint the source of the problem.
Where is my pain coming from?
• Disk Herniation is the most common source of sciatica. Pressure on the sciatic nerve from a herniation or protrusion of a spinal disc can create an irritation and inflammatory response.
• Stenosis is the narrowing of space where the spinal cord or nerve roots exit the spinal canal. Pressure occurs on the cord or the nerves causing pain to radiate down the leg, typically seen in a condition called degenerative disc disease. Another cause of stenosis is tiny little bone spurs called osteophytes that can form in the spinal cord or nerve root space.
• Piriformis Syndrome is when the piriformis muscle in the buttock/gluts shortens and tightens or experiences spasms. In most of the population, the sciatic nerve runs just beneath the piriformis although in a small percentage, the sciatic nerve runs directly through the muscle. When the piriformis is taught or in spasm, the sciatic nerve can become compressed and irritated causing pain down the back of the leg.
• Trigger Point Referral Pain occurs when trigger points in the gluteus minimus, gluteus medius, and piriformis radiate pain into the back of the leg. Dysfunction of movement patterns, compensation for weaknesses, or postural deficits, among many other things, can cause the trigger points to become active and painful.
When should I seek sciatica treatment?
If you suspect sciatica or are experiencing pain in the back, buttocks, or down the back of your legs, it’s important to seek out sciatica treatment as soon as possible for the best chance of a quick recovery. Waiting will only cause the symptoms to worsen and can potentially cause long-term issues. Sciatica physical therapy can help to determine the source of the nerve irritation or referral origin and treat it accordingly.
How can sciatica physical therapy help me?
The source of your sciatica can usually be determined through a musculoskeletal exam conducted by a physical therapist, without the need for medical imaging. Treatment plans for sciatica pain relief will vary based on the source of the pain but may include:
• Core stabilization exercises, both static and dynamic, in conjunction with lumbar range of motion are effective in reducing sciatica symptoms.
• Patient education on proper sitting and standing postures as well as proper body mechanic training can help to avoid causing further damage of disc herniation.
• Home exercise programs to help stretch the piriformis, hamstrings, and glute muscles. Combined with sciatic nerve glides/flossing, these stretches can be very effective at getting the sciatic nerve moving again if it is trapped by the piriformis.
• Joint mobilization, massage therapy, and myofascial release are also common techniques to inhibit an active trigger point.
Physical therapists can provide the necessary tools to prevent and/or treat sciatica, allowing you to return to your favorite activities pain-free and better than ever! To learn more about sciatica pain relief and sciatica treatment, book a physical therapy assessment today.
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