Sciatica is a common term used to describe pain that is referred into the leg from a source in the lower back. Sciatica usually occurs following an injury to one of the discs in the low back. Discs allow movement between the spinal vertebrae and provide shock absorption. They can be injured in a number of ways with the most common from heavy lifting or after maintaining prolonged positions. Pain into the leg can occur from discs themselves or from pressure on one of the spinal nerves.
The pain associated with sciatica can vary, however it is usually described as a deep ache through the buttock and down the back of the leg and can continue all the way to the foot. Associated neurological signs may be present which include pins and needles, numbness and occasionally weakness. The source of sciatica can usually be diagnosed during a thorough examination by a physiotherapist and confirmed as required with MRI or CT imaging.
Management of sciatica pain is dependent on the severity of the condition. Initially rest from the aggregating activities is required with some pain and/or anti-inflammatory medication. Early physiotherapy management is essential to allow for the healing of the injured disc and promote adequate strengthening.
Treatment may consist of:
- Education regarding the injury
- Advice regarding safe daily activities
- Massage therapy
- Spinal mobilisation
- Taping to support the back
- Exercises to improve mobility and strength
- Rehabilitation programs to prevent further injury
Only the most severe cases will require further investigations and medical management. In some specific cases injections or surgery may be required. However most people with sciatica will respond well to conservative physiotherapy management, particularly when addressed immediately.