What is Sciatica?
Sciatica is the common term given to pain which is referred from the lumbar spine. Depending on the level of spine which is affected, the pain can be present in the back, buttock, or down the leg.
Pain often runs down the back of the leg, but may also affect the groin, front or side of the leg. Compression of a lumbar nerve can result in this referral. Nerves can become compressed due to a disc bulge, aggravating by chemicals released from an injured disc or osteophytes which can impinge on the nerve.
Common signs and symptoms
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Acute low back pain
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Muscle spasm
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Restricted ability to move
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Referral of pain or symptoms into buttocks or down leg
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Pins and needles
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Numbness
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Altered sensation
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Weakness
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Aggravated with sitting, turning over in bed, driving,
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List or lean to one side
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Possible disturbances to normal gait, bladder or bowel function
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What Causes Sciatica?
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Repetitive loading can result in a worn, weakened area of the disc. This degeneration can eventually manifest into a disc protrusion or herniation. Often it may only take a trivial action. The mechanism of injury usually involves flexion and/or rotation, and in some cases compression
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Osteophytes can impinge on where the nerve exits the spine.
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Irritation of a nerve can occur from chemicals released by an injured disc.
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More common between the ages of 20 and 50 years.
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Influenced by repetitive, manual jobs or activities.
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Sedentary jobs / lifestyles which involve prolonged periods of sitting.
How Can I Self-manage Sciatica?
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Stay Active: Gentle movement and low-impact exercises like walking, swimming, or yoga can help reduce inflammation and improve mobility.
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Use Heat and Cold Therapy: Apply a cold pack to reduce inflammation during the first 48 hours, then switch to heat (like a heating pad) to relax muscles and improve blood flow.
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Practice Good Posture: Sit with proper lumbar support and avoid slouching. Use a supportive chair and take frequent breaks if sitting for long periods
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Stretch Regularly: Gentle stretching of the lower back, hips, and hamstrings can relieve pressure on the sciatic nerve.
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Avoid Heavy Lifting and Twisting: These movements can aggravate sciatic pain. If you must lift, do so with proper technique, using your legs, not your back.
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Manage Pain with OTC Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce pain and inflammation if needed. Always follow the recommended dosage.
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Immediate assessment must be sought if you have any of the following symptoms:
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Disturbance to normal bladder, bowel, or sexual function
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Problems walking normally
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Associated unexplained weight loss
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Severe night pain unrelated to movement
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Worsening peripheral symptoms
What your physiotherapist can do to help?
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Reduce pain and inflammation by:
- Joint mobilisation
- Massage
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Prescribe exercises to restore mobility and improve core stability
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Taping
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Traction
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Pilates education
Our London Physiotherapy Clinics
We also provide visiting physiotherapy to your home, care home or office
Further management
If symptoms worsen, peripheralise, or affect bladder, bowel or sexual function, then immediate assessment by a GP or A&E is necessary.
Improvement should be noted within 4-6 weeks. Long term management should entail ongoing Pilates and mobility exercises.
Maintenance manual treatment can be useful to prevent recurrences.
Assessment by a specialist may be required if symptoms do not improve or become worse.