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?

Most commonly, sciatica is caused by a herniated disc, which compresses the nerve root and causes inflammation. It may also be caused by osteoarthritis, spinal stenosis or piriformis syndrome, where narrowing around the nerve causes irritation. Poor sleep, unhealthy diet, being overweight, increased stress and previous history of back issues can also contribute to this condition. In rare cases, sciatica may be caused by something more sinister, therefore it is important to get it checked out if you are concerned. Sciatica can often resolve spontaneously after a few weeks, but sometimes it may take months for the symptoms to settle down. With a wealth of experience managing patients with sciatica, I can help to identify potential triggers for your symptoms and work with you to improve your pain levels, and help you return to the things you love doing.

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. I have many years of experience in managing patients with sciatica and will be able to advise you whether an MRI is necessary indicated or not.

Cauda Equina Syndrome (CES)

In rare cases, compression of a bundle of nerves in your lower back called the cauda equina may occur. 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

• Progressively worsening muscle weakness in your legs

I have several years’ experience in treating and managing patients with sciatica and offer treatments including manual therapy, exercise prescription, education and advice. I offer all my patients a thorough assessment and bespoke treatment plan, to help them achieve their goals and get back to what they love doing.

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If you are struggling with sciatica or back pain, submit a booking form through my website or contact me on 07971818756 to book an appointment.