Sciatica: How Physical Therapy Can Help
Sciatica is nerve pain that radiates from the low back through the buttocks and down the length of the leg due to compression of the sciatic nerve. Originating in the low back, the sciatic nerve is most commonly compressed by a herniated or slipped disc causing shooting pain and tingling and numbness through the back and leg. Physical therapy is one of the most effective treatments for sciatica, reducing inflammation, managing and minimizing pain, improving your physical function and mobility, and preventing the reoccurrence of sciatica symptoms.
What is the sciatic nerve?
The sciatic nerve originates in the low back and is the longest nerve in the body. It runs through the pelvic area, passing beside or directly through the piriformis muscle region, branching out of the lumbosacral plexus, a bundle of nerves in the pelvis. It then travels into the buttocks and down the back of both thighs. The sciatic nerve plays an important role in lower body function, providing direct motor function to the hamstrings and lower extremity adductors and indirect motor function to the calf muscles and anterior lower leg muscles.
What is sciatica?
Sciatica refers to pain that radiates down the path of the sciatic nerve. Pain can begin in the low back and extend through the buttocks and back of the leg. Pain can range from a mild ache to severe, shooting or burning pain. At times, pain may be experienced as an electric shock or lead to tingling, numbness, and muscle weakness in the affected leg. Nearly 40% of people will experience low back pain and sciatica at some point in their lives.
Physical Therapy for Sciatica
Physical therapy is one of the most effective treatments for sciatica pain management and relief. Physical therapy can reduce inflammation, manage and minimize pain, improve physical function and mobility, and prevent the reoccurrence of sciatica symptoms.
Passive treatments for sciatica pain:
Use of ice and heat to manage pain and inflammation. Heat facilitates more blood to the low back to bring more oxygen and nutrients to the area for healing. Using ice can slow circulation and reduce inflammation, pain, and muscle spasms.
Electrical stimulation using a TENs unit stimulates muscles through variable but safe intensities of electrical current to reduce muscle spasms and increase the body’s production of endorphins, the body’s natural painkillers.
Ultrasound generates sound waves that travel deep into the muscle tissues and create gentle heat to enhance circulation and speed healing.
Manual therapy can involve deep tissue massage and soft tissue mobilizations, targeting the low back muscles and fascia (muscular connective tissue) in the lumbar spine, hips, and buttocks that may be compressing the sciatic nerve.
Dry needling involves inserting thin filiform needles into hyper-irritable taut bands of muscle tissue that may be referring pain and compressing the sciatic nerve.
Active treatments for sciatica pain:
Targeted stretching to increase flexibility and relieve pain in the low back, hips, and legs.
Therapeutic aerobic exercise such as lumbar extension exercises to centralize sciatica pain to the low back and improve overall fitness.
Spinal decompression using traction to relieve pressure on the spine. Traction can be done manually or using a traction machine, which uses weights and pulleys to apply gentle force to tissues surrounding the damaged area and relieve nerve compression.
Resistance training targeting the low back, hip, abdominal, and gluteal muscles to strengthen the spinal column muscles for proper spinal alignment as well as provide a strong base of support to the low back through a stronger core, glutes, and hips.
Aquatic therapy in our warm water therapy pool which not only relieves pain and inflammation in the low back but also helps patients build strength and improve fitness using the gentle resistance of water.
Posture and ergonomics education to protect your spine and minimize aggravating movements and re-injury risk.
Functional retraining for proper technique when lifting, carrying, bending, and squatting.
