What is Sciatica?

Sciatica is a term used to describe pain, pins and needles and/or numbness in the legs due to irritation of the sciatic nerve in your lower back. The sciatic nerve is the largest nerve in the body; it begins in your lower back and runs down your leg and into your foot.

Causes of Sciatica:

Sciatica arises when the sciatic nerve is irritated. Such irritation can occur from a number of things including:

Intervertebral disc dysfunction in the lower back
Facet joint dysfunction in the lower back
Tight piriformis muscle – the sciatic nerve runs under this muscle in some people; when it is tight, irritation can occur
Sacroiliac joint dysfunction
Lumbar spondylolisthesis – forward slip of one vertebrae on another
Lumbar stenosis – narrowing of the spinal canal

Symptoms of Sciatica:

Symptoms of sciatica vary from person to person but can include:

Buttock and leg pain (often only on one side)
Burning, shooting or tingling pain
Pain that increases with sitting
Pain that decreases with lying down
Sharp pain that can interfere with walking

Assessment of Sciatica:

Your All Care Physiotherapist will ask you questions regarding the onset and behaviour of your symptoms, and then complete a thorough assessment of you, which may include:

Range of movement in your lower back, hips and pelvis
Strength, sensation and reflexes in your legs
Nerve mobility
Individual spinal joint movement
Core muscle strength

Treatment of Sciatica:

Management of sciatica will vary from person to person depending on the cause of your sciatic pain. Your All Care Physiotherapist will be able to determine the main factor contributing to your leg pain. Treatment of sciatica can include:

Pain relief
Gentle movement exercises
Soft tissue release
Dry needling
Core strengthening exercises
Nerve mobility exercises
Heat or ice
Walking program

What Can You Do to Help?

1. Lumbar (lower back) Rolls:

2. Progression of Lumbar (lower back) Rolls:

3. McKenzie Extension Exercise:

4. Flexion in 4-point Kneeling:

5. Piriformis Stretch:

6. Transversus Abdominis Contraction:

The transversus abdominis is a deep core muscle that is part of the corset-like action that works to stabilise your spine.
When you have back pain, the transversus abdominis does not activate as often or as strongly, which can further contribute to your back pain.
The contraction of the transversus abdominis is a very gentle contraction (about 20% effort).

How to activate your transversus abdominis:

Lying on your back, bend your knees up so you are comfortable.
Place your hands on the inside of your hip bones to feel the muscle contracting.
Breathe in, breathing into your stomach.
Gently breathe out and then pause your breathing.
Draw in through your lower abdominals; you should feel a gentle tensioning underneath your hands. If you feel a bulge you are trying too hard! Keep your ribcage still.
Transversus also works with the pelvic floor, so it may also help to try and activate the muscles that stop the flow of urine.
Holding the contraction, begin breathing again into your stomach.
Aim for 10 x 10s holds. You should be able to feel yourself begin the contraction and also feel when the contraction is relaxed. If you cannot feel the contraction relax then try for a shorter duration hold.

To get control of your sciatica, call All Care Physiotherapy today on 1300 291 133 and get back to the activities you enjoy!

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