Health and wellbeing Sciatica

Sciatica is the name given to pain that radiates along the path of the sciatic nerve, usually causing low back pain, buttock or hip pain, and pain down the back of the leg.

What are the symptoms of sciatica?
The main symptoms of sciatica include:
    • Pain in the low back and buttock radiating into one or both legs, sometimes as far as the foot
    • Tingling, pins, and needles sometimes with numbness in the leg or foot
The pain may be position or activity-dependent. Some people also experience weakness in the leg.
What causes sciatica?
Sciatica is caused by compression or irritation to a nerve root. The nerve root is the name given to the segment of the nerve as it comes off the central spinal cord.
The most common causes are:
    • A bulging disc (also referred to as a “slipped disc”) – the bulge can press on the nerve root
    • Spinal stenosis – narrowing of the ‘tunnel’ the nerve root passes through
    • Injury to soft tissues, such as muscles or ligaments – this can cause inflammation around the nerve root which can irritate the nerves.
How is it diagnosed?
Diagnosis is usually made from the history and a simple examination. An MRI scan may be advised if symptoms aren’t improving.
How can I manage my sciatica?
The good news is that the majority of people with sciatica recover within six weeks with advice, exercise, and education.

The research into sciatica consistently shows that adhering to the seven golden rules of back pain management are the most important things you can do to help ease your symptoms, and avoid recurrence.

Seven golden rules of back pain management
    1. Keep moving. Your back is designed to move – studies show that longer periods of rest and avoiding activity actually leads to more pain, longer recovery times and a long time off from work.
    2. Keep living and working normally
    3. Avoid bed rest during the day
    4. Exercise. This might make your back feel a bit sore at first but it doesn’t cause any harm. Start off slowly and gradually increase the amount you do. Over time, your back will get stronger and more flexible and this should reduce your pain. These exercises are specifically designed to help with sciatica.
    5. Don’t sit down for too long
    6. Don’t be afraid to take simple painkillers in order to return to your usual. Painkillers such as paracetamol and ibuprofen or anti-inflammatory gels may be helpful to control the pain and allow you to continue exercising. Discuss this with your GP or Pharmacist. If the pain down your leg is severe, it may be worth seeing your GP to discuss whether some nerve pain modulating drugs might help.
    7. Stay active and remember to reintroduce activities
Sedentary and inactive lifestyles increase the risk of developing pain in your back and can also delay your recovery. Being active for 30 minutes in your day can make a big difference in your overall health and improve your pain.
Are there any signs or symptoms to be concerned about?
Sciatica is rarely a sign of a serious problem, although the pain can be very unpleasant. The pain experienced does not mean more damage is occurring; it’s more a reflection of the fact the nerve root is very good at causing pain if it is irritated.
However, if you experience the following complaints you should seek urgent help via your nearest emergency department for urgent assessment.
    • Inability to pass urine when you feel the need to go
    • Inability to stop a bowel motion or leaking
    • Numbness in or around your back passage, buttocks or between your inner thighs
    • A change inability to get an erection
    • If you have pain in both legs and/or worsening weakness in the legs
Further management options
If there is no response to the self-management information above within four to six weeks, seek further advice from your Physiotherapist or GP.

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