Sciatica is a term that gets bounded around for a whole host
of signs and symptoms, so we at Chart Clinic would like to offer our knowledge
in helping to understand this.
So what is Sciatica?
Sciatica is when the Sciatic nerve (that runs from your low
back/ pelvis, all the way down the back of the leg and into the foot) becomes
compressed, stretched or inflamed. This leads to pain in the low back and back
of the leg and foot, often accompanied by pins and needles, numbness and/ or
weakness in the leg. It is important to note that the leg pain is often worse
than the low back pain. Another common symptom of Sciatica is the inability to
pull your foot up when you walk, giving the appearance of dragging the foot
when walking.
The Sciatic nerve is one of the most common nerves to injure
in the lower extremity due to the many sites of potential injury.
What causes it?
The most common reason for Sciatic nerve pain is from trauma
or surgery around the hip. It has been documented that 1-3% of all hip
replacement surgeries result in Sciatic nerve injury. Hip fracture and
dislocation are also reasons for potential Sciatic nerve entrapment.
Piriformis Syndrome, another term you may have heard of, is
another area where the Sciatic nerve can become irritated. If the muscle,
Piriformis (which is located deep to the buttock muscles), is overly tight then
this can lead to buttock tenderness and pain into the back of the thigh. Prolonged
sitting, bending forwards and certain hip movements can exacerbate these
symptoms, often accompanied by numbness into the back of the thigh.
The nerve then traverses down in between the hamstrings
where a muscle strain here can compress the nerve. The Sciatic nerve then
divides behind the knee where one branch wraps around the top of the Fibula
bone. A fracture here can then lead to pain into the calf and foot, along with
pins and needles, numbness and/ or weakness of the ankle and foot.
What can you do?
This is entirely dependant on the reason why the Sciatic
nerve is being compressed. As physical therapists, we are trained to diagnose
the reason for a patient’s signs and symptoms through special tests. This is
where it is important to differentiate between nerve root irritation (where the
nerves come out the spine are inflamed) and peripheral nerve entrapment (where
the spinal nerve roots converge) as the signs and symptoms are similar but not
the same.
If the Sciatic nerve is being compressed by muscles or
tendons, then physical therapy can be very effective in helping to alleviate
these symptoms. Very specific stretches and the use of ice and/or heat can also
help.
Due to the vast number of causes for low back pain and leg
pain, it is best to speak to a manual therapy specialist to help diagnose and
treat the area in question as it is important to identify where the origin of
pain lies so it can be treated accordingly.
The above Information is not designed to replace medical
advice. Serious Injuries should be managed with assistance from your Physical
Therapist or Health Professional. With any symptoms that cause concern or
doubt, get them checked out.
