sciatic syndrome - Demystifying Sciatica
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Demystifying Sciatica

What is sciatica? Sciatica is the official name given to a pain in the leg, foot, or buttock, brought on by a form of irritation to the sciatic nerve, the longest nerve in the entire body.

Ilia rotation - this assesses weather the ilia is rotated on one side creating imbalance. What can a Physical Therapist or GP do? Use diagnostic tests to discover the cause of the problem.

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 Being extremely uncommon in younger patients sciatica can still affect most anyone. Most people who suffer from sciatica are in the age range of thirty to fifty. Most often back injury or over exerting the back will bring on a sudden onset of sciatica.

Essentially what is happening is that there is some nerve or nerves are getting irritated. A common reason is due to your spinal discs. They're supposed to hold onto liquid and slowly compress throughout the day. If you have a burst disc or one that is too low, your vertebrae will actually grind together and most likely on a nerve. You can also experience the pain of sciatica when a tight muscle compresses on a nerve. The idea of the exercises is to help get the stress off the nerves and get rid of the pain.

What other injuries are related or similar? Piriformis syndrome Sciatica Sacroiliac joint pain. The Sacroiliac joint Is? The Sacroiliac Joints are located at the bottom of the back. You have one either side of the spine. The Sacroiliac joints help make up the rear part of the pelvic girdle and sit between the sacrum and the ilia.

Sciatica Symptoms Acute low back pain. Pain radiating down the leg. This pain may be sharp and accompanied by pins and needles and / or numbness.

Pain is often triggered by a minor movement such bending over to pick something up. Pain may be worse by sitting, lifting, coughing or sneezing.

It is important to stay active. Do exercises that develop muscles in your back and stomach. This helps to stablilize your spine. It is also important to maintain a reasonable body weight. Ensure that you practice good posture, and sleep on a mattress that is neither too hard or too soft. You should always discuss health matters with your physician, especially if you suffer progressive weakness, as this may constitute a medical emergency. The problem thought to be something easily treated may be a serious condition caused by the compression of the nerve roots in the lower end ofthe spinal canal, which requires immediate medical attention.

Depending on where the sciatic nerve is pinched will determine where you feel the pain which can radiate to the front of the knee or right down the back of the leg to the foot. The L5-S1 disc is the disc most commonly damaged and the L4-L5 disc the next most commonly damaged.

Apply electrical stimulation in the form of a Tens machine or Interferential. Apply ultrasound treatment. Operate on a slipped disk if neurological signs (nerve related symptoms) continue or worsen.

Laser Back Surgery. Discover more information on sciatica.

A prolapsed disc or slipped disc as it is sometimes known is not simply a disc that has 'slipped' out of place. Intervertibral discs separate the bones of the spine (or vertebrae) and their function is to act as shock absorbers or cushioning for the spine and allow movement.

Proper stretching and exercising, combined with over-the-counter pain medications can assist on the road to recovery. If your pain is not relieved by the milder pain medications, your doctor may prescribe a naroctic analgesic. However be advised that these medications can cause nausea, dizziness, and drowsiness, and may result in dependency if taken over long periods of time. In extreme cases, surgery may be required to remove fragment of the disc.

Specific assessment tests: The Stork test - to assess weather the sacroiliac joint is moving correctly. Leg length difference measurements - both straight leg and bent leg assessments.

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What are the symptoms of pain referred from the back? An aching in the buttocks that is difficult to pinpoint. The slump test may reproduce buttock pain which is eased when the neck is relaxed back (extended).

Inflammation of the sacroiliac joints and associated ligaments are very common, especially following pregnancy where the hormone relaxing is released and this results in the relaxation of ligaments in preparation for childbirth. In most cases the causes of sacroiliitis are mechanical, however there may be other medical inflammatory conditions present such as Ankylosing Spondylitis as well as others which will need attention.

These joints can often get stuck or in some cases one half of the pelvis can glide forwards or backwards, which is often referred to as a twisted pelvis. When this occurs it often irritates the Iliolumbar ligament which results in Inflammation. This is usually indicated by tenderness around the bony lumps which you can feel if you place your thumbs either side of your lower back.

The intervertebral discs are filled with a soft liquid in the middle called nucleus pullouts and when a disc prolapses this liquid squeezes out and puts pressure on the spinal cord compressing the nerve routes and causing pain.

So you have been diagnosed with sciatica and even though your doctor explained to you about the condition, you have come looking for a bit more information on sciatica.

Lumbar Spinal Stenosis: This is the narrowing of the spinal canal causing sciatica type symptoms. Disk problems and arthritis of the spine can cause this narrowing.

What can a Physical Therapist professional do? Manipulate and mobilize the segments of the lumbar spine. This is a good way of assessing whether the lumbar spine is a cause of buttock pain. If it is then symptoms will be relieved.

Sacroiliitis: The joint where your hip meets your spine is called the sacroiliac joint. When your sacroiliac joint becomes inflamed it is known as sacroiliitis. Sciatica type syndromes can be felt due to inflammation caused by arthritis or traumatic injury. Anesthetic injections or anti-inflammatory medications can take away the pain.

What are the similar or related injuries and conditions? Ankylosing Spondylitis Myofascial pain Low back pain Coping with Sciatica

Occasionally there may be referred pain into the lower limb which can be mistaken for sciatica. Classic symptoms are difficulty turning over in bed, struggling to put on shoes and socks and pain getting your legs in and out of the car.

Deep tissue sports massage techniques can be applied to the lower back and buttocks to release muscle tension, particularly in chronic conditions. Acupuncture or dry needling can also help reduce chronic tension in muscles.

Iliolumbar Syndrome: This is simply inflammation or a tear of the ililumbar ligament. This is the back of your pelvis and it extends from the spine to the iliac crest.

Pain is usually relieved by lying down, often on one side. Pain is often better in the morning after a nights rest. Scoliosis or an S shaped or bent spine as seen from behind is often present with the patient bending away from the side of pain.

The sciatica exercises that relieve back pain are really easy. The first one involves you laying on your back and pulling your knees up to your chest, giving them a hug. The idea here is to stretch out the lower back, which rarely ever gets a stretch. The other exercise is grabbing onto something above you and allowing it to stretch out your upper body. It's sort of like hanging on the monkey bars.

Lets start with the basic question on most peoples mind, what is sciatica? The general term used for pain being felt along the sciatic nerve is sciatica. This pain is usually described by patients as a sharp electric shocking type pain that starts in the buttocks and travels down the back of the thigh and leg. Most often caused by a herniated disk, there are also other causes. When diagnosing sciatica symptoms a MRI scan is most often taken to help with this process. If your MRI shows a herniated disk make sure to get referred to a spine specialist. A spine specialist can look over your X-rays and be able to recommend the proper course of treatment.

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After the acute painful phase Restore pain free movement to the back through mobilization and stretching techniques. Ensure posture and correct lifting techniques are learned and maintained.

Sciatica is most commonly caused by a slipped disc in the lower back, some form of arthritis, or a pinched nerve. It begins with back pain, followed by calf or hamstring pain, and sometimes included numbness in the toes. Forms of sciatica, resulting from inflammation get better with time, healing themselves. However, bed rest is not the best way to treat sciatica. It is shown that remaining active and performing exercises that are not weight bearing can help. Given time, even herniated spinal discs can heal.

The pain may radiate out into your buttocks and low back and will often radiate to the front into the groin. Occasionally it is responsible for pain in the testicles among males.

Stiffness in the lower back when getting up after sitting for long periods and when getting up from bed in the morning. Aching to one side of your lower back when driving long distances.

I wanted to talk to you about sciatica exercises that relieve back pain. Most people would say that back pain is probably about the worst pain that you could ever experience. It's not like a paper cut that effects a tiny fraction of your body. Back pain is an electrical storm of pain that travels across your back. It's crippling in a way because any little movement could lead to it. You could be reaching into your refrigerator and you feel the sharp pains spread throughout the back. It's a rough time and being able to get easy relief is important. This is why I wanted to share with you sciatica exercises that relieve back pain.

A Pain deep in the cheeks of your bottom can be referred from the lower back. There does not necessarily have to be pain in the lower back as well for pain to be referred into the buttocks.

Sports massage will help relieve any soft tissue tension in the area. Use injection therapy. Advise Ice and cold therapy to reduce inflammation.

Sciatica is a pain that starts in the back and radiates down one of the legs. It is quite a common complaint and is sciatica is caused by pressure on the sciatic nerve which runs down into the leg. The medical term is acute nerve root compression. The cause of pressure can be varied from a Slipped (Prolapsed) disk to muscle tension (Piriformis syndrome) or something less common such as a tumors, bony growths and infections.

They quite happily allow flexion and extension (bending forwards and backwards), lateral flexion (sideways movement) and twisting. However a combination of the two can put excess stress on the spine and damage the discs. This is particularly common in people who may lift heavy objects and twist with them for example unloading heavy boxes off the back of a lorry.

Lumbar Facet Joint Syndrome: The pain coming from the joints in your back with this particular symptom can cause Sciatica like symptoms along with pain and discomfort. Just like the knee and elbow can get inflamed and cause pain, the facet joint is like any other joint in your body and follows these same rules.

Eliminate medical diseases such as Ankylosing Spondylitis.. Treat the cause as well as the symptoms. Prescribe anti-inflammatory medication (e.g. ibuprofen) and rest.

Some signs and symptoms of sciatica are: A cramping sensation of the thigh Shooting pains from the buttock, down the leg Tingling, or pins-and-needles sensations in the legs and thighs A burning sensation in the thigh Maneuvers such as squatting, coughing or sneezing worsen the sciatica symptoms that the patient is having. The cause of the worsened sciatica symptoms is the jerking motion adding pressure that is being placed around the nerve. I mentioned earlier that sciatica is not always caused by a herniated or slipped disk. Some other causes of Sciatica could be:

There are torsional or twisting forces applied to the pelvic girdle when the lower limbs are moved. These limbs act like long levers and without the sacroiliac joints and the pubic symphysis (at the front of the pelvis) which allow movement, the pelvis would very likely be subject to a fracture.

Symptoms include: Pain located either to the left or right of your lower back. The pain can range from an ache to a sharp pain which can restrict movement.

Use sports massage techniques to relax tight muscles. Gently apply mobilization techniques to the spine. Use traction or advise on the use of and Inversion Table.

Sciatica treatment A Short Rest in bed if necessary in a position that is comfortable. A doctor may prescribe NSAID's (non steroidal anti inflammatory drugs) such as ibuprofen. Should always be taken under the direction of a doctor and do not if the patient has asthma.

Use electrotherapy equipment to treat affected tissues. If indicated and safe to do, level the pelvis via manipulation. Articulate sacroiliac joint and restore normal function.

Begin an exercise programme that will stretch and strengthen the muscles supporting the lumbar spine. Stretch the gluteal muscles and hip rotator muscles.

Treatment for sciatica is varied. It is only possible to find out what treatment is best for you by going to your doctor for an accurate diagnosis. Your doctor may order an MRI to conclude the exact cause of sciatic pain, although many physicians can determine the cause through physical examination alone.

Areas of the lumbar spine may be tender and have poor mobility. Tight gluteal muscles and other muscles of the buttocks. What can I do? See a Physical Therapist who can identify the problems in the lower spine.

Begin extension exercises as soon as pain allows. What can a Physical Therapist or GP do? Determine the cause of the sciatic pain. Prescribe anti-inflammatory medication e.g. ibuprofen or muscle relaxants.

Apply heat or a hot bath may help to relieve muscle spasm. Use a heat retainer or back brace can provide support in the early stages. See a sports injury specialist or doctor.

Piriformis Syndrome: Simply put this is pain caused by the Piriformis muscle that may be in spasm, inflamed, or irritated. Located in you buttock and laying right on top of the sciatic nerve as it exits the spine down your leg. When this muscle is inflamed, irritated or in spasm it will cause pressure on the sciatic nerve causing the sciatica like symptoms.

Learn more about the Sciatica Stretches That Work

There may be muscle spasm in the lower back. Tenderness in the lower back when pressing in. Pain on the straight leg raise test which is not apparent when just stretching the hamstring only.

Strengthen the core stabilizing muscles of the spine.

Terry O'Brien

Tracy B. Wheeler


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