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Sciatica is an irritation of the Sciatic nerve, causing pain down the back of the leg. As it’s a nerve-generated pain, it can be quite severe in nature and doesn’t respond to the usual range of over-the-counter medications like anti-inflammatories. And while Sciatica can occur with back pain, Sciatica itself can’t cause back pain.
Why classic treatments often fail
Sciatica requires a different Physiotherapy approach compared to other causes of leg pain, such as lower back nerve irritations or muscle/tendon problems affecting hamstrings and calves. This is because Sciatica is caused by a different type of irritation and won’t respond to the usual treatment approaches used on other conditions, such as stretches or strength exercises – in fact, hamstrings stretches can actually make it a lot worse!
Although pain is the classic symptom of Sciatica, you might also experience pins and needles or numbness (however these tend to only come on for a few minutes or an hour). Sciatic pain won’t refer up higher than the buttock but can often be associated with a separate lumbar issue, which can cause simultaneous back pain. The nerve irritation may cause a cramp-like feeling, particularly in the calf muscle and under the foot, like the muscle is about to go into spasm.
Gaining some relief from Sciatica can be challenging when you explore the options yourself. There’s often a long delay between what you do and how it feels, so you won’t find out until the next day that something made it angrier. It’s why the fastest way of relieving the pain is to seek professional help from an experienced Physiotherapist.
Effective treatment for Sciatica
In our Taren Point and Manly clinics, we’ve seen lots of active people with Sciatica over the years and we find that a combination of approaches works most effectively. These might include:
- hip mobility work and manual therapy**,
- trigger point and massage work around the deeper hip muscles, and
- some movement-focused exercises designed to restore normal function to the affected area around the hip, without overloading or fatiguing the muscles involved.
** It’s important to note that hamstring stretches often add additional pressure and irritation to the sciatic nerve and aren’t helpful, despite the feeling of hamstrings tightness.
The success of our approach is due to the interventions performed as well as the activities that are avoided or modified to relieve additional load on the nerve. Because there’s no point in doing some things right if you’re still doing the activities that are causing the problem.
The best news: the vast majority of our clients who presented with Sciatica get early relief within a few days and the condition is often resolved in under 3 to 4 weeks.
Medication
Although most medications are ineffective for Sciatica, there are some medications that are specific to nerve pain which can be used in more extreme cases.
An experienced Physio will be able to advise you on which medications may be helpful but most of these are only available with a doctor’s prescription.
Written by
Tim O’Grady
Physiotherapist
Tim is a Physiotherapist who specialises in football/Rugby and golfing injuries. Tim doesn’t believe that rest will make you a better athlete and he focuses on performance-based rehab methods. Tim is also qualified in golf biomechanics and injuries.
