Sciatica is pain produced by the largest nerve in the human body, the sciatic nerve. This is a leg dominant pain, however, it may be associated with back pain as well.

Anatomy

The sciatic nerve stems from the back and runs through the buttocks and down both legs. It branches off into several smaller nerves along the way. The nerve supplies the muscles of the lower leg, similarly to how a spark plug allows an engine to run. Nerves that branch off also help collect sensory information from our environment which is what allows us to feel.

Sciatica Symptoms

• Pain in the leg (constant, sharpshooting, electric)
• Pain in the back and/or buttocks
• Weakness
• Paraesthesia (abnormal sensation), such as numbness and tingling/ pins and needles / wet feeling

Causes

Sciatica can be caused by abnormal pressure and irritation to the nerve, commonly due to:

• lumbar disc herniation
• degenerative changes to the lumbar spine
• spinal stenosis
• tightness in leg and hip muscles
• poor posture
• prolonged sitting (see – How To Set Up An Ergonomically Friendly Workspace)
• increased weight

Treatment for Sciatica

Treatment with a physiotherapist may include:

• Back strengthening exercises
• Stretching
• Manual Therapy
• Therapeutic Positioning
• Ice or Heat (see – How to know when to ICE vs. HEAT an injury)
• TENS
• Acupuncture

Some of the best exercises to help relieve your sciatica include the following:

• Clamshells
• Seated Figure 4 Stretch
• Glute Bridges
• Dead Bug
• Bird Dog
• Active Hamstring Stretching
• Sciatic Nerve Flossing

Sciatic Nerve Pain Medical Management 

Your doctor may also prescribe pain medication, muscle relaxant, or anti-inflammatory drugs (NSAIDs). In certain severe cases, surgery may be considered and a referral will be made.

In most cases, you would be referred for conservative (instead of surgery) treatment. Your physiotherapist will take a thorough history and perform a physical examination to help establish or confirm the diagnosis as well as help decide the most appropriate course of treatment for you.

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