Sciatica Pain

                           Sciatica Pain

The sciatic nerve is the longest nerve in the body, going from the pelvis, through the buttocks, down the legs to the feet.

Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg is the hallmark of sciatica. You might feel the discomfort almost anywhere along the nerve pathway, but it's especially likely to follow a path from your low back to your buttock and the back of your thigh and calf.

The pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating pain. Sometimes it can feel like a jolt or electric shock. It can be worse when you cough or sneeze, and prolonged sitting can aggravate symptoms. Usually only one side of your body is affected.

Some people also have numbness, tingling or muscle weakness in the affected leg or foot. You might have pain in one part of your leg and numbness in another part.

Piriformis syndrome

Piriformis syndrome is an uncommon cause of sciatica. The piriformis is a muscle that lies deep underneath the gluteal muscles of the buttocks. The function of the piriformis muscle is to externally rotate and stabilise the hip. The sciatic nerve passes directly underneath the piriformis. Piriformis syndrome occurs when the piriformis muscle becomes tight, goes into spasm, or swells. When this happens it compresses the sciatic nerve beneath it. In roughly one in 7 people, the sciatic nerve passes through the piriformis instead of underneath it — and these people may be prone to sciatic nerve problems.

Role of Physiotherapy In Sciatica

Sciatica Treatment

PHASE I - Pain Relief & Protection

Physiotherapy treatment of sciatic nerve pain will vary based on the cause and presentation of your symptoms, and will be individualized to your own case. However, there are a few general principles that we follow in terms of treatment. The first step is to address the pain,inflammation, and acute phase of sciatica. Modalities such as TENS, IFC, ultrasound, and laser may be used. You may also be advised to apply ice to the affected area (usually the low back or buttocks) every few hours for 15-20 minutes at a time.

Manual Therapy -

Manual physical therapy is a specialized form of physical therapy delivered with the hands as opposed to a device or machine. In manual therapy, practitioners use their hands to put pressure on muscle tissue and manipulate joints in an attempt to decrease back pain caused by muscle spasm, muscle tension, and joint dysfunction.

Manual Physical Therapy can Offer Pain Relief for Acute and Chronic Back Pain

As a group, manual physical therapy techniques are aimed at relaxing tense back muscles and restricted joints in order to decrease back pain and increase flexibility. In general, manual physical therapy techniques employ the following types of movement:Manual therapy can be helpful for the treatment of joints that lack adequate mobility and range of motion in certain musculo-skeletal conditions. This limitation can cause discomfort, pain, and an alteration in function, posture, and movement. Manual physical therapy involves restoring mobility to stiff joints and reducing muscle tension in order to return the patient to more natural movement without pain. Thus, manual physical therapy may provide back pain relief both for patients with chronic back pain involving joint problems, such as sacroiliac joint dysfunction, and acute back pain from soft tissue injuries such as a back muscle strain or a pulled back ligament. Although extensive clinical studies have yet to be performed on all areas of manual therapy, limited clinical data and patient reports support the assertion that manual physical therapy can be effective in relieving back pain for certain patients.

 

PHASE II - Restoring Normal Flexibility, Posture & Strength

As your pain and inflammation settles, your physiotherapist will turn their attention to restoring your normal back joint range of motion and resting muscle tension, lower limb muscle flexibility and posture.

Your physiotherapist will assess your muscle recruitment pattern and prescribe the best exercises for you specific to your needs. They may recommend that you undertake an ultrasound guided exercise program where you can view your deep core muscle contractions on a monitor. 

PhysioWorks has developed a Back Pain Core Stabilisation Program to assist their sciatica patients to regain normal core muscle control. Other more advanced programs can include stability exercises and equipment such as a Swiss exercise ball. Please ask your physio for their advice.

Swimming and hydrotherapy exercises are beneficial in early injury repair due to lesser body-weight in the buoyancy of water. This allows more movement without causing pain.

PHASE III - Restoring Full Function & Dynamic Control

The next stage of your rehabilitation is aimed at safely returning you to your desired activities. Everyone has different demands will determine what specific treatment goals you need to achieve. Your physiotherapist is the best person to guide your rehabilitation.

PHASE IV - Preventing a Recurrence

Sciatica does have a tendency to return. The main reason it is thought to recur is due to insufficient rehabilitation.

Fine tuning your back mobility and core control and learning self-management techniques will ultimately help you to achieve your goal of safely returning to your previous sporting or leisure activities without sciatica.

Exercise is like cleaning your teeth. Exercise prevents problems. 

Sciatica Prevention

What you can do

	Use a seat support to improve posture whilst sitting
	Practice exercises to strengthen spine supporting muscles

Posture plays a major role in the development of disc related Sciatica. Prolonged sitting and bending postures, where the lumbar spine is 'flexed' increase the pressure on the discs. This can lead to disc degeneration and a Herniated disc, and should therefore be avoided.

In order to avoid a recurrence of the problem it is important to take better care of back posture. An understanding of good posture is necessary to achieve this. Viewed from the side, the spine consists of a series of curves:

The curves increase the load-carrying capability of the spine compared to if the spine was just straight. The lumbar part of the spine consists of a forward curve and as long as this is maintained, posture will be reasonably good. It is important that this improved posture is maintained during all activities, particularly when sitting for long periods - slumping should be avoided.

A Lumbar Roll placed at the bottom of the back or a Seating Support can be effective when sitting. Driving for long periods should be avoided if possible and where it is unavoidable regular breaks with stabilising exercises is a good idea.

In the long term, good posture is maintained by increasing the muscular stability of the spine. This can be achieved through specific stabilising exercises.

For Further Advice & Consultation :Contact

Dr.Vijay Bathina

Chief Physiotherapist

SYNAPSE PHYSIO CARE

09848857464,09885657380

http://synapsephysiocare.com/

For appointments

https://www.practo.com/hyderabad/doctor/dr-vijay-physiotherapist-6