Do you ever experience a burning sensation down the back of your leg? Does the pain get worse when you bend forwards, sit, or cough? If you’ve answered yes to any of these questions, you might be experiencing sciatica! Luckily, sciatica is considered “self-limiting,” which means it should resolve itself within 4-6 weeks (sometimes longer). Physiotherapy can be helpful in reducing symptoms and increasing functionality in your daily life.

What is Sciatica?

Sciatica is a broad term that is used to describe the course of the pain, rather than being a specific diagnosis. Sciatica is a nerve pain that commonly radiates from the buttock and down the backside of the leg. This pain is caused from an irritation or compression of the sciatic nerve. Did you know that the sciatic nerve is the largest nerve in the entire body? It’s thickest section spans 2cm wide! Sciatica affects around 10-40% of the population, often seen at ages 30-50. It’s also more commonly seen in certain occupations such as: machine operators, truck drivers, and carpenters.

What causes Sciatica?

The most common cause of sciatica is from a herniated disc, which is the phenomenon where a part of your spinal disc shifts out towards the spinal canal, leading to nerve irritation and/or compression. Although this sounds like a very serious situation, disc herniations are actually very common – most people who have herniated discs are asymptomatic, meaning they don’t report any symptoms or pain. With that being said, there is a percentage of people who do report symptoms and pain; if the sciatic nerve is involved, these individuals get categorized under the term sciatica. Other possible causes of sciatica can include spinal stenosis (narrowing of the spinal canal which reduces the space available for the spinal cord and nerves), age-related disc degeneration including bone spurs, or a malignant tumour (rare cases). You might be wondering: is diagnostic imaging necessary to determine the extent of the issue? The answer is no! It is important to note that what is shown on imaging doesn’t always correlate to the amount of pain or symptoms someone may be experiencing. Furthermore, the imaging results will not drastically change the possible treatment options. The only time that diagnostic imaging is considered is when symptoms are getting progressively worse after 12 weeks.

What are the symptoms of Sciatica?

The symptoms of sciatica can vary from person to person depending on which nerve is impacted. Oftentimes, people experience sharp or burning pain starting in the lower back or buttock area, down the back of the leg and calf, and sometimes down to the feet. Sciatica usually affects one side of the body – very rarely does sciatica happen in both legs. Some people may experience a tingling sensation, numbness, or a feeling of pins and needles down the affected leg. The pain can be constant or intermittent and it usually gets worse with certain positions or movements such as coughing, sneezing, prolonged sitting or standing, bending forwards, standing up, or twisting the spine.

These symptoms can be very distressing and negatively affect your everyday life and productivity. If you are experiencing more severe symptoms such as weakness or loss of feeling in the affected leg, changes or loss of bladder and/or bowel function, please seek medical attention (eg. your family physician) as soon as possible.

How can Sciatica be treated?

Physicians and physiotherapists will determine if you have sciatica based on your presenting symptoms as well as the findings from the physical exam. With sciatica, conservative management is the favoured treatment option; therefore, physiotherapy is a great option to consider, as the goal of physiotherapy is to find ways to manage your pain while also improving your function in everyday activities. Physiotherapists can work with you to ensure your self-management techniques and exercises are tailored to your specific symptoms and needs. Exercises can include strengthening of the core, thigh, and calves, as well as gentle stretching components. Nerve gliding exercises can also be included in your exercise program, which has been proven by research to be effective in managing sciatica symptoms. Nerve gliding is an important aspect to consider because we want to enable the nerves to continue sliding smoothly through different tissues of the body – this will help reduce inflammation and symptoms that you may be experiencing.

Other treatment options can include getting corticosteroid injections for temporary pain relief of approximately 6 weeks or visiting a massage therapist to relax tight muscles that can be contributing to the pain. Surgery can also be considered after all conservative treatment options have been exhausted.

What can I do to help manage Sciatica?

Here are five tips to assist with your recovery process of sciatica:

1. Keep your body moving!

Contrary to the common belief, we want to avoid bed rest as much as possible. The body is designed to move; therefore, we suggest that you continue your everyday activities as you normally do! If you are in a lot of pain, try using over-the-counter medications (eg. Tylenol or Advil) to help ease the pain. Be sure to talk to your pharmacist or family physician first to determine if these medications are suitable for you.

2. Avoid activities or movements that increase your symptoms.

There may be certain tasks or positions that can aggravate your symptoms. Try avoiding or modifying activities that bring on those symptoms. If you are having difficulties figuring out how to modify tasks, our physiotherapists would be happy to give you a few ideas on what you can do.

3. Adopt regular changes in postures/positions.

As mentioned earlier, prolonged positions like sitting and/or standing can bring on those terrible symptoms. Try changing positions every 30 minutes or prior to the onset of your pain. In terms of sleeping position, try laying on your side with the painful side facing up towards the ceiling. Make sure you add a pillow between your knees for more comfort!

4. Use heat/ice on the area.

To ease some of your symptoms, simply apply heat or ice (whichever one you prefer) to decrease inflammation and increase comfort.

5. Keep an eye out for worsening symptoms.

It is important for you to notify your physiotherapist or family physician if any of your symptoms are getting worse. Keeping track of your symptoms can help determine which treatment methods are effective and which are ineffective.

At Boost Physiotherapy, our physiotherapists are ready to assist you with any pain or conditions you may have! If you think you are experiencing any sciatica symptoms, talk to one of our physiotherapists and they will work with you to determine which treatment option best suits your needs. If you have any further questions about sciatica, book an appointment online or call us today at 587-635-555 (South Edmonton) or 780-591-5555 (Stony Plain). Our physiotherapists will be happy to assist you in any way!