Sciatica is a specific type of pain that radiates down the sciatic nerve. Which extends from your lower back, into the glutes and down the back of the legs, however sciatica generally takes place down one side of your body. The main cause of this happening is when a herniated disk, which is bone spur on the spine, compresses part of the nerve. This can cause numbness and pain in the legs and also inflammation. Generally this is not considered as anything serious and in most cases will goes away after a few weeks. On rare occasions a patient may need surgery but this is only a result if there is a significant weakness in the legs.
Anatomy
The sciatic nerve is the biggest and longest nerve in the human body, starting at the base of the spine, into the gluteal region and running down the back of the leg into the toes. The sciatic nerve is formed in the lower spine by the combination of motor and sensory fibers from spinal nerves L4 to S3. These spinal nerves belong to a larger group of nerves in the lower spine called the lumbosacral plexus.This long, thick, nerve then divides into the Peroneal and Tibial nerves which innervate different parts of the lower leg, foot and toes.
Symptoms
Pain that forms and travels through your legs up via your glute and into your back is the biggest and most common sign that you may have sciatica. Discomfort can be felt almost anywhere but this is more apparent through the nerve pathway through the areas stated above. Feelings such as burning pain can be felt through sciatica and this may be mild or severe. This can sometimes feel worse or be more painful when you sneeze or cough, additionally sitting for a long period of time can also aggravate this more. Another main symptom is numbness or tingling, this is commonly known as the phrase pins and needles. Muscles can also tighten and become weak in the leg and foot.
Causes
Sciatica occurs when an overgrown bone is on your vertebrae/ herniated disk in your spine and results in the sciatic nerve getting pinched.
Some factors such as age can not prolong sciatica. There is sometimes nothing you can do to stop this. Obesity can also be a factor as this puts stress on your spine and the extra weight can cause spinal changes leading to sciatica. Your job can also play part as a factor, for example if you have a heavy lifting job or a job that requires you sitting down for long periods of times like driving long distances. Diabetes can also enhance sciatica because of the way your body uses blood sugar, and increases your risk of nerve damage. Finally not being active can also trigger sciatica.
Diagnosis
Sciatica is commonly diagnosed through the patients history taking and physical screening. By definition patients mentioning the radiating pain in the leg will spark the sciatica diagnosis. They may be asked to report the distribution of the pain and whether it radiates below the knee and drawings may be used to evaluate the distribution. Sciatica is characterised by radiating pain that follows a dermatomal pattern.Physical examination largely depends on neurological testing. The most applied investigation is the straight leg raising test.
Treatment
As stated before sciatica can go on its own so in most cases you won’t have to do an awful lot however some cases are worse than others and there are various things that you can do to help treat this. Easy things like making sure that you stretch regularly can help massively. This allows you to keep your muscles stretched out and start to stimulate the nervous system.
A qualified soft tissue specialist providing Sports Massage can be really beneficial with techniques such as Soft Tissue Release and also Nueromuscular therapy. This also helps stretch the muscles and really stimulate the nervous system by increasing the blood flow especially in the legs.
It is also important if this persists to seek help from a qualified sports therapist or physiotherapist who can work with you on a rehabilitation plan that will involve exercises and stretches.
Exercises
Glute Max Stretch
- Start Position: Lie on your back with your knees bent and feet flat on the floor.
- Movement: Cross your right ankle over your left knee, forming a “figure 4” shape with your legs.
- Action: Reach your hands through your legs and pull your left thigh towards your chest.
- Hold: Maintain this position for 20-30 seconds while feeling a stretch in your right gluteus maximus.
- Switch: Repeat on the opposite side.
Piriformis Stretch
- Start Position: Sit on the floor with your legs extended straight in front of you.
- Movement: Cross your right leg over your left leg, placing your right foot flat on the floor next to your left knee.
- Action: Twist your torso to the right and use your left elbow to gently press against the outside of your right knee.
- Hold: Hold this position for 20-30 seconds, feeling a stretch in the right piriformis muscle.
- Switch: Repeat on the opposite side.
Hamstring Stretch
- Start Position: Sit on the floor with one leg extended straight in front of you and the other leg bent with the sole of your foot against your inner thigh.
- Movement: Reach forward towards your toes of the extended leg while keeping your back straight.
- Action: Lean forward from your hips until you feel a gentle stretch along the back of your thigh.
- Hold: Hold this stretch for 20-30 seconds.
- Switch: Repeat with the opposite leg.
Quadricep Stretch
- Start Position: Stand upright, holding onto a wall or chair for balance if needed.
- Movement: Bend your right knee and bring your heel towards your buttocks.
- Action: Grab your ankle with your right hand and gently pull it closer to your buttocks.
- Hold: Hold this position for 20-30 seconds, feeling the stretch in the front of your thigh.
- Switch: Repeat on the opposite side.
Trigger Point the Piriformis Muscle
- Start Position: Sit on the floor with your knees bent and feet flat on the ground.
- Equipment: Use a foam roller or a small, firm ball.
- Placement: Position the foam roller or ball under your right buttock, near the area where you feel tension or discomfort.
- Action: Slowly roll your body over the roller or ball, applying pressure to the piriformis muscle. You can adjust your body angle to target different areas.
- Duration: Spend about 1-2 minutes working on each side, focusing on areas of tightness or tenderness.
- Switch: Repeat on the opposite side.
Please see some exercises and stretch examples in our video provided or alternatively contact one of our personal trainers who can talk you through these exercises.
Prevention
As Sciatic can be idiopathic it is not easy to prevent its occurrence. If possible avoid repetitive activities, when unavoidable take time to perform stretches and take regular breaks. Be aware of the first signs of symptoms developing, the earlier you start treatments the quicker it can be resolved.
If you are suffering with Sciatica
