SCIATICA



sciatica giving pain to buttock and leg requiring physiotherapy treatmentWhat is it?

A description of symptoms that present as pain referring down the buttock or leg, occurring from an underlying cause usually within the lower back.

Causes:

Herniation of one or more of the lumbo-sacral vertebrae compressing the nerve roots as they exit from the spinal canal. Stenosis or narrowing of the spinal canal can also be a cause due to bony spurs or spondylolisthesis (slipped vertebrae).


Piriformis syndrome can compress the nerve if this muscle becomes tight due to overuse or trauma. Sciatica can also occur during pregnancy.

Signs & Symptoms:

Typically presents on one side of the body however can cause bilateral symptoms, referring into the buttock, thigh, knee and at times into the foot and toes. These symptoms can often be described as a sharp, burning pain or a tingling/numbness radiating down the leg. Sciatica can be present with and without any lower back symptoms and will often impede the ability to weight bear or walk on the affected leg.

Treatment:

Early diagnosis through testing will help to determine the cause of the sciatica often without the need for radiological imaging. This will target the direction treatment needs to take. Although bed rest may help the acute symptoms settle, early mobilisation and exercise is key to reducing the symptoms of sciatica. In chronic cases pain management specialists can assist with these conditions. Physiotherapy is essential in these cases both as a prehab and recovery phase to improve back mobility and strength. Core strengthening and flexibility exercises will also reduce recurrence.

Prognosis:

If diagnosed early the prognosis can be very positive (6-12 weeks) and help prevent further episodes of sciatica. Conditioning exercises such as Pilates and core strengthening along with a specific stretching program can reduce the risk and prevent further aggravation. Severe cases can take over 3-6 months.