Nifwl Seirff



Sciatica

Disclaimer: I am not a doctor, the information on these pages is gathered from my own experience, books, websites, and other people's experience. I will not be held responsible for any injury resulting from this information. If you have a medical condition, you should seek qualified medical advice and supervision at all times.

 

What is Sciatica?

Sciatica is a chronic and often severely painful condition. The sciatic nerve leaves the base of the spine to travel down each leg, when gets pinched it causes inflammation in the muscles around it (which pinched the nerve even more). It may get pinched between the vertebra, or by muscles surrounding the spine.

The pain is registered as a continuous ache typically through one side of the buttocks (sometimes both) and down the back of that leg (or both). Usually the pain stops at the knee, but it can continue to the foot. Pain may also register in the hip joint, or lower back.

When sciatica is coupled with other painful conditions acting in the same area, it often creates a 'feedback loop', the pain from the sciatica aggravating the pain in the abdomen, and vice versa. Adenomyosis and endometriosis are particularly affected.

Sciatica can be caused by an injury, poor posture, bad lifting techniques or weak abdominal muscles.

A variety of medications are used to manage the pain of sciatica, but physical therapy is recommended. Bed rest should be avoided as it prolongs and doesn't solve the problem.

McKenzies physiotherapy exercises for back pain are particularly good for those who have piriformis syndrome (compressed sciatic nerve in the buttock area).

Luckily, a range of natural treatments work well to reduce sciatic pain.

 

How is it detected?

This is another condition which is diagnosed by elimination, though the pinched nerve and/or inflammation may show in xrays or CAT scans of the lower back. Usually inflammation can be detected by physically probing the are (though it is usually too painful!)

A bone scan may show inflammation around the lower back, and will detect if sciatica is caused by a bulging disc or spine deterioration.

How is it treated?

Physical therapy and specific stretches seem to work best in most cases. Ultrasound is used when the muscles are too sore for physical manipulation (massage), heat packs and anti-inflammatory creams are used in conjunction with these treatments.

Anti-inflammatory or other pain medications are often prescribed, but do not deal with the cause, only the symptoms.

Other treatments that may work include chiropractice, yoga, tai-chi, chinese medicine and gym (ball work).

There are a small set of stretches that seem to work the best:

  1. Lying on your back, legs straight, bring one leg up to the chest, hands clasped around the knees and hold for 20-40 seconds. Repeat with the other leg. Do this about 10 times each side.
  2. Lying on your back, feet flat on the ground, knees bent, bring your arms and head to one side and drop your knees to the ground on the opposite side to your arms. This twisting stretch releases tension around the spine where the sciatic nerve exits.
  3. The cat stretch is another popular one - on hands and knees, arch your back to the ceiling and bring your head and neck towards the floor, and breathe out. Breathing in, bring your head up to look at the roof, and arch your back in the other direction.
  4. Lying on your back, bring both of your knees to your chest and clasp your hands around your knees. Roll your knees in a circle, massaging the lower back. Repeat in the other direction.

Physiotherapists will often set exercises to strengthen the trans-abdominal muscles (the deepest level muscles in the abdomen, that wrap around the spine). Strengthening these muscles takes strain away from the lower back, as they aid posture, lung capacity and cushioning of the spine when walking. Learning to tense only the trans-abdominal muscle is a good place to start, and then doing ball work at gym using that muscle is the best way to strengthen it.