Sciatica

What is Sciatica?

The term refers to pain that travels down the back of your leg from the lower back or buttock as far as the foot.  This is caused by irritation of the sciatic nerve and is often accompanied with back pain but more often the leg pain is worse than the back.

Cause

Nerves leave the spine through small tunnels made by the bones of the spine.  Some of the nerves in the lower back merge to form the sciatic nerve which runs down each leg. This happens on both sides of the spine so you may suffer sciatica in either leg.  If the nerves are irritated where it travels through the tunnel due to a swollen joint, muscles or ligaments or a bulging disc, in some cases pain can occur anywhere along the length of the sciatic nerve.

Why does the pain travel down the leg?

This is because of the nerve irritation described above. The irritation leads to severe shooting pains traveling down all or part of the sciatic nerve along its path in the leg; this may be accompanied by pins and needles and/or numbness.  The sciatic nerves send messages to the brain about the irritation and makes the brain think there is a problem with the nerve itself and not in the back which is the cause of the pain.

What should you do?

As with other back or neck related pains the key is to keep active but you may need pain killers to achieve this, and you cannot do yourself any harm in doing so.  Following either a GP consultation or appointment with PhysioHey you will be given advice and exercises.  Advice will relate to keeping active which will stop your muscles becoming tight and weak, which may cause problems in the longer term.  You will experience some pain and discomfort during your recovery but this is not harmful.

Are there signs or symptoms to be concerned about?

Sciatica is rarely a sign of a serious problem, but is unpleasant when you are suffering this form of pain. The pain experienced does not mean more damage is occurring.  Many cases of sciatica resolve without specialist input when given good advice and most others resolve within 4 weeks.

However if you experience the following you should seek urgent help;

  • Being unable to pass urine when you feel the need to go
  • Lose control of your bowels
  • Go numb around your bottom/groin
  • Unable to get an erection
  • Have pain in both legs and/or worsening weakness in the legs

If you are unable to discuss the above symptoms with your PhysioHey clinician or a doctor you should attend your nearest Emergency Department for urgent assessment.

Treatments available for sciatica

You should see your doctor or contact your local community MSK service who will provide initial advice and assessment (this may be over the telephone) as well as advising on pain relief if you are not already taking some.  It takes time for symptoms to start settling down. If they are not improving you may be required to attend for further assessment and treatment.  Occasionally surgery may be required, but you should give you body chance to recover on its own first.

If you need further advice or just need reassurance things are progressing as they should contact your doctor or local community MSK service.  Their expertise will quickly ascertain if your symptoms have changed or deteriorated and will modify your treatment and/or pathway.

Back pain is a ‘musculoskeletal disorder’ (MSD) which also includes neck pain and repetitive strain injury (RSI), now known as Work Relevant Upper Limb Disorder (WRULD).  MSDs are a main cause of people being off sick from work.  Physiotherapy is extremely effective with MSDs. In one study, 80 per cent of people who had physiotherapy for their MSD were able to carry on working and did not have to go off sick.  Back pain has a wide variety of causes, from picking up a heavy parcel incorrectly to spending too long in one position.  Feeling very anxious or stressed can make your pain worse.  It is rarely due to a serious health problem.

Physiotherapy work wells for managing back pain. If you see a physiotherapist quickly, this can not only speed up recovery but also prevent the problem happening again.  A physiotherapist will first check out if you have a serious health problem that may be connected to your back pain, this may be done over the telephone in the first instance. They will then find the reason for your back pain and look at ways to help prevent further problems.  Physiotherapy and osteopathy offers a range of treatments that have proven to be effective with back pain. These include manual treatments, exercise, and acupuncture.  You will be advised on appropriate exercise and pain relief.

There is a lot you can do to help yourself. Continuing with your usual work and activities, as much as possible, can help your back pain. There are exercises that can reduce your back pain and help to prevent it returning. The right sort of exercise, as advised by a physiotherapist, can make a big difference.

Research has shown lower back pain may return if it is ignored. Lifestyle changes, such as being more active and improving your posture, are important.

Top tips for back pain

  • Exercise and activity are the most important ways of helping yourself if you have back pain
  • Keep moving and continue with activities such as walking or swimming
  • Paracetamol or similar pain-killers, taken as advised by your health professional , can help you keep moving comfortably
  • Avoid sitting for too long when driving or at work
  • Gently stretch to prevent stiffness
  • Take care when lifting, bending your hips and knees to use the power in your legs
  • Check your posture when using computers/games or watching television
  • Check the mattress on your bed to ensure it supports you properly
  • Don’t smoke – it impairs your circulation, which affects how quickly your body can recover
  • Strengthen your trunk muscles as this may help to protect your back
  • Make sure your car seat and office chair are adjusted correctly and support your back
  • Eat a healthy diet and exercise, as being overweight can be a cause of back pain

For more information regarding back pain and its costs to you and your employer click below;

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