What is sciatica?
Sciatica is pain due to an impingement or irritation related to the sciatic nerve or nerve root. The sciatic nerve is a large nerve
formed from nerve roots that originate from the spinal cord. These nerve
roots pass out between the disc spaces
and join up to form the sciatic nerve.
Sciatica is a very broad term to describe ongoing lower back and leg pain, particularly affecting the buttock area. You may experience
symptoms from your lower back all the way down to your feet.
Sciatica occurs when the nerve roots in your lower back become compressed, pinched or irritated, resulting in varying levels of pain.
This could be caused by a number of reasons:
or bulging lumbar intervertebral disc
- a spinal condition that causes one of the lower vertebrae to slip forward onto the bone beneath it resulting in the nerve roots being
- although uncommon, the piriformis muscle in your buttocks lies directly above the sciatic nerve. If the muscle becomes tight, swollen
or spasms, then it can compress the sciatic nerve beneath it.
- when the space available for the nerves in the spine narrows, it can put pressure on the nerves in this area.
- Leg length difference that changes the way you move
which can occur with ageing.
- Poor strength and mobility in lower limbs
Trauma from a car accident, falling down or contact sports (i.e. rugby) can place external forces on the nerve roots and
injure or compress the nerves.
Who's at risk
There are a number of factors that can put you at a higher risk of developing sciatica:
Age: Usually the middle aged or older population is more affected, as the discs in the spine change and weaken with
Occupation: Jobs that require prolonged periods of sitting or awkward positions, or require you to carry heavy loads
could have an impact.
- Sedentary lifestyle: Inactive people with poor strength and mobility.
- Obesity: Excess body weight can increase the stress placed on the spine.
- Muscle imbalances and dysfunction
- Walking and running patterns that overtime may affect and tighten the piriformis muscle.
- Diabetes: People with diabetes have an increased risk of nerve damage.
Pregnancy: Hormonal changes, the position of the baby and the extra stress placed on the back during pregnancy can greatly
increase your risk.
With sciatica, you will most likely experience shooting pains or constant pain that starts in your lower spine, then radiates through your
buttocks and down the back of your leg.
Other common sciatica symptoms include:
- Muscle weakness
- Altered walking and running patterns with poor hip stability
- Poor balance
- abnormal sensation of the skin (tingling, chilling, burning or numbness) with no apparent physical cause.
- Pain worsens with prolonged sitting and occasionally standing.
- You may experience some numbness or tingling in your buttocks, legs and feet.
It is usually a burning, tingling or sharp pain, as opposed to a dull ache. If it is a dull ache it may indicate it is more related to
your muscle rather than nerve.
It's important to note, that sciatica can vary in severity, so two people could experience very different symptoms. One may have a dull
ache, numbness or tingling, and another could have a burning or stabbing pain that prevents them from walking or standing.
The signs and symptoms of sciatica closely resemble those of other lower back and hip conditions, hence why it is important for one of our
podiatrists to diagnose your condition and formulate a treatment pathway. We may require a second opinion or aid from another allied
health professional to enable the most effective treatment pathway.
Generally avoiding aggravating activities will settle the symptoms and applying a gentle heat pack can help relax and soothe the area.
If the pain has not subsided after a few days, we recommend seeking medical attention from one of our podiatrists to see if we can help
When treating sciatica, we often suggest an individualised combination of treatments to allow you to achieve the fastest and most effective
- Strengthening and stretching exercises, in conjunction with foot mobilisation techniques (FMT)
- Appropriate, supportive footwear
- Pain-relieving and anti-inflammatory medication
- Custom prescribed foot orthotics may be recommended if you have a difference in leg length
- Foot and ankle strapping may be beneficial
- Dry needling of surrounding soft tissue structure to help relieve tension on the muscles
Depending on your condition, our podiatrists may recommend conjunctive treatment with another health professional.
Below, we have outlined some of the stretches you can do to help your condition. However, we recommend consulting with our podiatrists
to get a personalised treatment plan to ensure they are going to be effective for you.
These are on harvard's website. Would we recommend ones like these? Have to
changing the wording if so.
Lie on your back with both knees bent. Pull your left knee to your chest, and hold this position for five to
10 seconds. Repeat on the other side. Do five to 10 times with each leg.
Lie with your knees bent. Pull both knees to your chest and hold this position for five to 10 seconds. Rest
and repeat. Do five to 10 times.
Lie with your knees bent, and cup your hands behind your head or stretch your arms to the side. Flatten your
lower back to the floor. Hold this position for five to 10 seconds. Rest and repeat. Do five to 10 times.
What can happen if I ignore sciatica?
Although rare, if you ignore sciatica pain, you could experience some of the following complications:
- Permanent damage to the sciatic nerve, due to constant compression of the nerve.
- Loss of motor control and sensation in the affected leg.
- Numbness, tingling and some muscle weakness in the affected leg.
- Prolonged periods of severe pain.
Although sciatica is not preventable in all cases (e.g. from degenerative disc disease, an accidental fall etc.), there are a number of
approaches that you can take to protect your back and prevent the condition.
- Exercise regularly to strengthen the muscles in your back and core, that work to support your spine.
to decrease the strain placed on your back and spine.
- Use good ergonomic posture while sitting or standing, especially at your job.
- Avoid sitting for long periods of time.