Many people who have lower back or hip pain might also experience pain radiating down the back of one or both legs. This phenomenon is known as sciatica and is caused by irritation of the sciatic nerve. This irritation or compromise of the sciatic nerve can happen at any point in the sciatic nerve’s distribution. It can happen at the level where the nerves come out of the spinal cord, as it traverses underneath the muscles of the lower back or glutes or even as it travels under the muscles of the hamstring and calves in the back of the leg.

Before we treat the sciatica, it is important to establish what is causing the nerve to be irritated and compromised and target our treatment around this cause. Some common causes of sciatica include:

• Piriformis syndrome (tightness in the piriformis muscle of the glute compromising the sciatic nerve)

• Herniated or prolapsed disc irritating the nerve roots as they come out of the spinal cord

• Osteoarthritis in the lumbar spine itself

• Osteoporosis in the lumbar spine causing reduction in disc height and available space for the nerve to travel through

• Poor lifting technique or poor bending habits

• Poor posture (e.g. prolonged sitting or poor mattress)

Physiotherapy is able to assess for signs of sciatica through subjective examination of your symptoms and history of your condition, assessing your movement particularly that relating to the lumbar spine and putting the sciatic nerve under stress. Further diagnostic imaging such as a CT, MRI or ultrasound can also confirm this diagnosis.

Physiotherapy can benefit and relieve sciatica in many ways, but the type of treatment administered will once again depend on the cause of your sciatica as mentioned above. Some common treatments utilized to treat sciatica include:

• Spinal mobilizations

• Massage and trigger point therapy

• Stretching tight muscles, joints and tendons

• Sciatic nerve glides to mobilize and release the sciatic nerve

• Advice on what things to avoid in order to not make the sciatica worse

• Advice on what exercises or treatment strategies would be beneficial to treat your sciatica to get you feeling back to 100% as soon as possible

If you have sciatica and would like advice on treating it, book an appointment with us today!