Physiotherapy is a first line treatment for Sciatica, a condition that involes the trapping or irritation of the sciatic nerve.
This is a big nerve that travels down the back of the thigh and into the foot. It originates in the lower lumbar nerve roots and passes through the pelvis, under (or through) the piriformis muscle and divides just above the knee before innervating the lower leg. Irritated nerves convey pain along the nerve length and this can be described as referred pain (Radicular). On a more profound level, compression of the nerve manifests in altered sensation, loss of sensation or pins and needles. Weakness and loss of reflexes may also be apparent if compression is sufficient. Most sciatica cases recover within 6 weeks and treatment can optimise/hasten recovery.
Nerve pain is seldom serious, although it can be terribly painful.
Pain is ‘lancinating’ or 'knife' like
Pain can have a mind of its own
Pain may also be like a deep ache - like tooth ache.
The pain can be associated with movement on bending forwards or backwards
Nerve odeama can have a latent effect. ie – you go for a walk, feel better and then its agony later in the day.
Mornings and weight bearing through the leg can be painful.
Activity can be helpful be very helpful
Sitting or rest is often aggravating.
Loss of sensation
Pins and needles
Weakness in the foot or leg (MUST BE ASSESSED!!!)
Slipped disc, or ‘prolapsed disc’, disc matter leaks or pressurises the nerve.
Bony thickening around the joint where the nerve exits the spine (Stenosis).
The piriformis muscle may spasm and can be a primary cause, altough rare.
Massage and myofascial release techniques
Exercise like McKenzie method
Nerve mobilisers where th nerve is moved inside the nerve bed (the tissues around the nerve).
Acupuncture /Dry needling / electroacupuncture