Sciatica is a term that describes pain relating to the sciatic nerve, which runs from your lower back (lumbar) to your feet. The pain is felt in the lower body, generally within the lower back and hips, but often can travel as far down as the knees. The pain can increase when weight is placed or bared down on the affected side.
I am sure many of us have met or known of somebody who has suffered from sciatica. Or maybe you have even experienced sciatic pain for yourself. According to UK statistics 13-40% of the population will experience sciatica in at some point in their lifetime. We certainly see this reflected in our clinic at Clearcut Physiotherapy with a high number of clients coming to us with sciatic pain.
How do I know if I have Sciatica?
Sciatica symptoms include –
- Numbness around the affected area, including the leg and foot
- Tingling sensation or pins and needles
- Pain when leaning into the affected side
- Pain worsens when sneezing or coughing
Physio for Sciatica
Let me give you a common case presentation we see and take you through what my treatment strategy for this patient would be:
This particular patient has lower back pain that is aggravated when staying in one position for an extended period (sitting for long hours at a desk) or when doing more movement than usually (going for a 1.5 hour walk). The pain begins in lower back and radiates into the glutes (buttocks) as an ache or burning pain before a sharp and shooting pain travels down the back of the thigh and they begin to experience pins and needles into there feet and toes.
When physically assessing this client there is loss of movement in the spinal, and referral of pain in to the legs. When palpating, there is muscle tightness and spasms in the gluteal region, and the lumbar spine area is tender to touch.
Treatment would begin with focusing on reducing irritation and giving pain relief. Therefore, we use plenty of hands-on therapy to desensitise the tissues aggravated to show the nervous system it is safe to tolerate loads.
To reduce tightness and muscle spasms experienced that contribute to pain we use soft tissue techniques such as massage, cupping, graston tools and massage guns.
Following this to desensitise the tissues we will begin soft tissue release combined with passive movement stretches. To further increase mobility we will use mobilisations and manipulations local to the area.
Alongside the hands-on therapy, we need to promote increasing levels of mobility at the lumbar spine and pelvis including the sacroiliac joint and the hip joint through therapeutic movement exercises. We begin to progress these by introducing core and gluteal engagement exercises. Strengthening these groups of muscles is what will primarily support your lower back during movement and maintaining a good posture.
We will progress with increased periods of time in our specialist rehabilitation gym a suitable exercise plan that works on a variety of lower limb compound strengthening exercises. These exercises include, squats, deadlifts, step ups, glute bridges, advanced matt based abdominal and core exercises that will start basic and progress to be more challenging by adapting the base of support and balance, adding weight, and adjusting the sets/reps completed.
Incorporated into our rehabilitation programme will be specific techniques to ensure correct biomechanical posture during movements so that your load is evenly distributed through the body and to identify any compensations that may cause long term issues or injuries. We also have a range of cardiovascular equipment such as a treadmill, exercise bike and cross trainer to include in our training that research shows promote movement that helps to prevent back pain.
I also send to my clients appropriate short pilates programmes they can complete equipment free in the comfort of their own home in between sessions or for going forwards after physiotherapy if they wish.
I would recommend for this person to come see us for a couple of weeks of intensive physiotherapy (twice weekly) as the symptoms are highly provocative to reduce the pain. I would then recommend for them to see me for a further 2-3 weeks for weekly physiotherapy as strengthening changes take around 4-6 weeks.
Hassan helped me with lower back pain which I experienced for a number of years and never got around to address. Hassan is a genuinely caring person, a great listener and communicator. He explained very clearly his approach and I always felt in the know. I have learned a lot how to take an active part in my recovery, have signed up for the gym for the first time in my life, have noticed a dramatic improvement in my back, and feel very positive about the future. Thank you Hassan, I am very grateful for your help.
So… don’t struggle with your sciatica! Book an appointment now and let us solve your sciatic pain for you!
