Sciatica is general medical term for pain that runs down the back of your leg, originating from the sciatic nerve or low back area.

Sciatica often occurs only on one side and may or may not radiate below the knee. Sciatica can present with back pain, but on occasion can simply be pain or pins and needles in the leg. Symptoms can be experienced into the buttock and back of the thigh, into the knee and calf or even as far down as the foot.

What Are The Symptoms Of Sciatica?

  • low back or buttock pain
  • pain down the back or outside of the leg
  • numbness / tingling / pins and needles down the back / side of the leg
  • a feeling of weakness in the leg on the affected side
  • pain or difficulty bending down
  • pain going down the leg when sitting or standing

The Anatomy Of Sciatica

The sciatic nerve is the largest and longest nerve in the body. At its largest point, it is the width of a thumb. The nerve originates in the lower back as the nerve roots leave the spinal cord through small gaps between the bones (vertebrae) of your lower (lumbar) spine. The sciatic nerve is made up of five nerve roots, starting at the bottom two lower vertebrae called L4 and L5. As the nerve travels down the leg it branches out to different parts providing sensory (feeling) and motor (movement) functions along the way all the way down to the foot.

What Is The Most Common Cause Of Sciatica?

Disc Issues: One of the most common causes of sciatica are issues with the discs between the vertebrae. These discs (a shock-absorbing pad between each bony vertebra) can bulge or prolapse backwards and can touch the nerve roots exiting the spine sending pain down the back of the leg.

When Should I Seek Professional Help For Sciatica?

  • If you need help with pain relief
  • If you have difficulty with mobility as a result of the sciatica
  • If you are struggling to sleep because of the sciatica / back pain
  • If you have pins and needles or numbness in the leg
  • If you have loss of strength in that leg
  • If you would like help to recover more rapidly
  • If you want to do as much as you can to help yourself
  • If you want to prevent the problem from recurring

Should I Go To A&E About Sciatica Or Back Pain?

Most back pain or sciatica is not serious and does not require emergency medical attention or visits to A&E.

In rare circumstances there is a need to attend A&E as an emergency on the same day. If you experience new onset of any of the following symptoms- one should attend A&E as an emergency:

  • Loss of feeling / pins and needles between your inner thighs or genitals
  • Numbness in and around your back passage or buttocks
  • Altered feeling when using toilet paper to wipe yourself
  • Increasing difficulty when you try to urinate
  • Increasing difficulty when your try to stop or control your flow of urine
  • Loss of sensation when you pass urine
  • Leaking urine, or a recent need to use pads
  • Not knowing when your bladder is either full or empty
  • Inability to stop bowel movement or leaking
  • Loss of sensation when you pass a bowel motion
  • Change in ability to achieve and erection or ejaculate
  • Loss of sensation in genitals during sexual intercourse

Luckily these symptoms are extremely rare.

How Can Physiotherapy Help My Sciatica?

  • First accurate examination and diagnosis of the problem.
  • Hands on treatment to relieve muscle spasm and pain.
  • Mobilisation of the spine to restore movement into the low back.
  • Mobilisations of the back and nerves to decompress the nerve.
  • Acupuncture for pain relief and to reduce muscle spasm.
  • Neural “flossing’ techniques to release the irritated nerve.
  • Exercises to relieve pain and reduce stiffness in the back.
  • Core strengthening to improve the body’s natural “corset” of support for the spine.
  • Much more…