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Sciatica - a proper pain in the b*m!

5 ways to help tackle your sciatica !

" Do you see a lot of back pain then ? " my patient asked me whilst I was treating his back yesterday. Most Physios will say that back pain and sciatica probably makes up 65-70% of our caseload. In our lifetime 80% of us will have at least one episode of back pain that lays us up for a few days and stops us doing our normal daily activities. For some lucky punters their back pain will have an accompanying sciatica just to add to the fun - yay ! But just what is the difference ? Why do some people develop sciatica yet others don't ? And what can you do about it ?

What is Sciatica ? .

Sciatica really a catch-all term for any pain or symptoms in the leg that originates from problems with the low back and irritations or compressions to the sciatic nerve. As nerves branch off from the spinal cord and leave the protective bony column they junction together to form the sciatic nerve which then runs out of the pelvis, through the buttock, down the back of the thigh and then splitting behind the knee to continue on down to the foot and ankle. The whole nervous system is really just a biological electrical wiring system with the sciatic nerve being the biggest and longest nerve in the body. The nerves ( just like wires ) carry electrical messages to and from the various parts of the body. So any irritation or disruption of this electrical system can lead to problems such as pain, pins & needles, numbness or weakness which can all be associated with sciatica.

What causes Sciatica ?

Sciatica is such a generic term so it can have many causes and because that sciatic nerve is so long there are many places along it's path where problems can arise. Here's just a few to be going on with :

  • Stenoisis or narrowing of the spinal joints- small extra bony fragments grow around the edges of the joint of the back which can narrow the bony cavities containing the nerves. Often this is a normal part of the aging process but sometimes it can happen as a result of trauma.

  • Slipped disc - it's an old fashioned term but one that we are familiar with so I'm using it. The disc is very strong and doesn't ' slip ' but rather bulges and can press against nerves irritating them and causing pain.

  • Piriformis syndrome - Piriformis is a muscle that sits in your bum cheek and travels across from your tailbone to the hipbone. The sciatic nerve runs very close by, and in some cases pierces through the muscle belly, so any swelling or spasm in the muscle can cause irritation of the nerve.

  • Pregnancy - another fun part of being pregnant is that hormones make the joints that little bit more supple which can place extra stress on the low back and pelvic regions.

What does Sciatica feel like ?

Most patients will describe anything from an irritating dull, achy pain in the butt and back of thigh to raging sharp, lancinating pain extending down to the ankle with numbness, associated weakness and everything inbetween ! Worth remembering that the amount of pain doesn't always correlate to the severity of the problem - think of a paper cut which feels like a huge, gaping gash but is really small and not serious at all. Nerves are sensitive souls and don't like being irritated but in the vast majority of cases sciatica will improve so I think the message is don't panic !

5 Ways to tackle Sciatica

  1. Rest - controversial I know ! Most literature and NHS advice is that you must stay active. To a degree yes, but if your back sodding hurts ( pardon my French ) then the last thing you need to do is keep irritating something so that it hurts some more ! Don't take to your bed for days on end but equally stop irritating a sore situation and let Mother Nature do her bit and start the healing process.

  2. Physiotherapy - yes, I know I'm biased but all too often we see people in pain weeks down the line when they have exhausted all the Dr Google has to offer, come to us only to find that they have been doing the wrong exercises for their particular problem. A stenosis type problem needs a different approach to a disc type problem. Get a proper diagnosis so you know what you are dealing with.

  3. Painkillers - I agree they are not a long term solution but getting some control of the pain is really, really important so that you can start to do some good rehab, get moving properly and most importantly... sleep !

  4. Exercises - but the right ones for your particular problem. Otherwise you could be barking up the wrong tree and not acheving what you need to. Treat your back like you would a sprained ankle, it needs rest initially but then you need to begin to get some load and movement going through it.

  5. Massage - many people find deep tissue massage and Reflexology really helpful with settling the muscle spasm, pain and helping with sleep. Restoring a normal movement pattern really helps with encouraging healing and stops you forming bad habits that can place extra stresses on an already stressed tissues.

When to seek emergency help ?

Fortunately in the vast majority of cases sciatica, whilst painful, isn't a cause for alarm or a dash to A &E. It lessens with time and can be managed well with some simple stratagies for the future. There are some instances with back pain which do require prompt medical attention in order to exclude any serious causes.

  • Saddle anasthesia - pins & needles or numbness around the genitals or groin area

  • Bladder & bowel disturbances - particularly any issues controlling your urine flow.

  • Weakness developing in legs - especially if both sides or with accompanying numbess.

  • Sudden changes in pain levels or distribution of pain.

Thankfully really serious problems are rare but if you are at all worried then give us a ring or contact your own doctor or medical team. To book an appointment with one of our Physio or Massage team then just give us a ring or book online by clicking on the link at the top of the page.


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