If you have sciatic neuralgia or “sciatica”, you know how painful and debilitating this condition can be. Sciatica is a type of nerve pain that is caused by irritation of the sciatic nerve. It is typically felt in the lower back, spreading through the buttock and down the leg, and can impact on your ability to work, sleep, exercise, and perform other basic tasks.
Here’s what you need to know about what causes sciatica, what steps you can take to help it, and what treatments are available.
What are the symptoms of sciatica?
Recognising the signs and symptoms of sciatica early is key to getting treatment that will help you recover from your pain faster. This can be tricky as other conditions can give you pain that radiates down the leg even if the sciatic nerve is not involved at all. Typical symptoms of sciatica include:
Pain which radiates from your lower back to your foot.
Patients diagnosed with sciatica often describe the pain as a sharp, burning, or a shooting pain which can be constant or intermittent. Sciatica usually affects one leg, but the pain can also alternate between legs or affect both at the same time.
Numbness, tingling, and weakness in the leg.
A sensation of numbness and ‘pins and needles’ or weakness in the foot or leg can be felt in addition to pain.
Pain that worsens when you move or stay in a certain position.
Pain that gets worse when you sit and lie down for long periods of time, bend over, twist your body, or cough can be signs that you have sciatica.
How is sciatica diagnosed?
A physical examination from an experienced clinician is often enough to confirm the diagnosis and eliminate other reasons for your pain. Getting assessed by your physiotherapist will also give you the opportunity to know what you can start doing about your pain.
Is it best to get a scan first?
No. In most cases of back pain, x-rays and scans are not necessary as they are rarely able to show the cause of pain. As such, they rarely change how your pain is managed.
In addition, scans often reveal changes in your body’s tissues that are often not relevant to your current pain, but rather the normal ageing of your spine. This can add confusion and unneeded worry for you and slow down your recovery.
How can sciatica be treated?
Your physiotherapist will need to examine you to provide the most appropriate treatment for your reported symptoms and health circumstances.
Generally, the recommended treatment strategies are:
Understand what triggers your pain.
You probably noticed that certain positions or movements tend to aggravate your pain. As much as possible, try to either reduce or pace them. It is ok to poke the bear a bit, but don’t try to beat the pain.
Movement and rest.
Movement that doesn’t increase your pain will help to speed up your body’s natural recovery process and relieve your pain. You should aim to remain active as much as you can through light exercise such as walking, cycling, or any other non-aggravating activity you enjoy.
Your physiotherapist can also help you find movements and exercises that you can do at home to help the irritated nerve recover.
Getting enough rest in between physical activity is also key, but you should also be mindful not to sit or lie down for too long as this can slow recovery.
When seated, try to frequently change your posture and note if certain postures relieve your pain. In the office, you can arrange for a standing desk to alternate your position or better ergonomic seating which is more comfortable for you.
Some medications are specific for nerve pain and can often provide relief. These will need to be prescribed by your doctor.
Hot packs, massage, creams, manual therapies, and other treatments can be tried and can in some cases help.
Finally, keep in mind that, as debilitating as pain can be, the majority of patients with sciatica improve or completely resolve over time even without any treatment.
When is surgery required?
There are some circumstances when urgent referral to a surgeon is necessary, such as when your leg loses strength rapidly or when symptoms in the pelvic area develop (i.e. loss of bowel or bladder control, or numbness and tingling in the genital area).
If you are experiencing any of the above symptoms associated with sciatica, our physiotherapist team can help you get a diagnosis and advise you on the best treatment for your condition.
You don’t need a doctor’s referral to come and see us at Brecken Health Care – simply pick up the phone and call us on (08) 9791 8133 to book your appointment today.