Sciatica

What is it?
Sciatica is a condition that affects the nerves in your lower spine. The sciatic nerve carries signals up and down your legs to control the sensation and movement of your limbs. Compression, irritation or inflammation around the nerve causes referred pain down the leg(s), which may be felt as a sharp, shooting, or burning pain, occasionally associated with pins and needles or numbness. Sciatica can be a very debilitating condition, particularly in the acute stages. Treatment usually involves a period of relative rest from aggravating movements, pain relief and physiotherapy.

What causes it?

Sciatica can be caused by many things, not just injury. Poor sleep, unhealthy diet, being overweight, increased stress and previous history of back issues can all contribute to this condition. A physiotherapist can help to identify possible triggers and work with you to calm the pain down and return to your hobbies and activities of daily living. Treatment may include massage, mobilisations, manipulations, exercise prescription and education.

What are the symptoms?

Sciatica symptoms can be difficult to pinpoint and will vary from person to person, but typical symptoms include:

• Lower back pain
• Shooting/burning pain down the leg(s)
• Pins and needles
• Numbness
• Weakness
• Hot/cold sensations in the leg(s)

Do I need a scan?

Sciatica can be diagnosed clinically, and imaging is not usually required. X-rays and MRI’s rarely change the management in the early stages and are generally not recommended. A scan may be considered in cases where the symptoms do not respond to conservative treatments within 12 weeks of onset, or if there is significant weakness or numbness indicating more severe nerve compression.

Our physiotherapists are experts in assessing and managing sciatica and will be able to advise whether a scan is indicated or not. Should you require a scan, your physiotherapist will be able to liaise directly with the GPs at The Medic Clinic to arrange this.

Cauda Equina Syndrome (CES)

In rare cases, compression of a bundle of nerves in your lower back called the cauda equina may occur. These nerves control sensation and motor power around the genitals, all the way down to your feet. CES is a medical emergency, so if you experience sciatica with any of the symptoms listed below, it is recommended to seek medical attention at your local emergency department as soon as possible.

• Bilateral leg pain and/or tingling/numbness
• Changes in bladder/bowel control or sensation e.g. difficulty initiating, unable to control or feel when you need the toilet
• Loss of sensation or tingling around the genitals and back passage
• Loss of sensation during sexual intercourse, inability to achieve an erection or ejaculate
• Developing a foot drop where you are unable to lift up your foot

If you are struggling with sciatica, book an appointment through our website or contact our reception team on 01234 984065 to book an appointment with one of our physiotherapists.