The sciatic nerve is the longest, thickest nerve in the body. It is made up of 5 spinal nerve roots in the lumbar and sacral spine, which converge and run from the lower back, through the buttocks and down to the knee, where it branches off and continues into the foot. There are 2 sciatic nerves in the human body, the left, and the right nerves, supplying the corresponding lower limb. The sciatic nerve controls numerous muscles in the lower legs and also supplies sensation to the skin in these areas.
Sciatica is the term used for a set of symptoms caused by other underlying problems
Although sciatica itself is not a condition, it is a set of symptoms caused by other underlying problems. You may also hear terms such as lumbar radiculopathy or radicular pain, which are interchangeable with the term sciatica. Common medical conditions that may cause sciatica include:
- Herniated lumbar disc
- Lumbar spinal stenosis
- Lumbar degenerative disc disease
- Spondylolisthesis
- Muscle spasm
- Sacroiliac joint dysfunction
These conditions may develop spontaneously or over a period of time due to trauma or a physical stress injury, for example; road traffic accidents, falls or sports injuries, can cause direct injury to the sciatic nerve. Conditions such as a herniated disc or spondylolisthesis may develop from physical stress injuries, such as weightlifting.
Treat sciatica as early as possible in order to avoid the progression of symptoms
Symptoms are commonly felt along the path of the sciatic nerve and tend to affect one leg, but in some cases both legs. These symptoms are often characterized by the following:
- Pain
- Numbness
- Tingling sensation like pins and needles
- Stabbing, burning or shooting
- Weakness
Symptoms may feel worse while sitting, trying to stand up, standing still for a period of time, bending and twisting the spine and lying down. You may find that the symptoms ease when walking or applying heat to the lower back.
Remain mobile and continue activity as much as possible
It is advisable to treat sciatica as early as possible in order to avoid the progression of symptoms. Sciatica treatment may include a combination of manual therapy, soft/deep tissue massage and exercise rehabilitation to strengthen the spines supporting muscles including the lower back, core and lower limb, stretch tight and inflexible muscles such as hamstrings and improve motor control and posture.
Modify activity
It is important that you avoid prolonged periods of physical inactivity and bed-rest. You must remain mobile and continue activity as much as possible. You may find that you need to modify the activity you are doing, for example; revise your long distance runs to interval walk/runs or maybe go for a swim instead.
If you suffer with sciatica try these exercises to ease your symptoms:
Child’s pose:
- Kneel down and sit on your heels.
- Keep knees about hip width apart.
- Place your hands on your thighs.
- Slide your hands down your thighs onto the floor in front of you supporting your weight as your trunk moves down toward the floor. If you are able to you may rest your forehead on the floor.
- Breathe deeply allowing your back to relax and hold this position for 30 to 60 seconds.
Lumbar Rotations:
Start this stretch by laying on your back, keeping shoulders as flat to floor as possible.
Version 1: Keep your knees together, let both knees lower to the floor, rotating from your lower back.
Version 2: Whilst keeping your knees together, lift both legs so your hips and knees are at 90 degrees, rotating from your lower back and pelvis, lower both knees to the side, aiming to meet the floor.
Version 3: Lift one leg up, rotate you lower back and pelvis to allow your leg to drop to the side, you may wish to use your arm to push your knee down towards the floor.
Hold for 30 seconds on each side and repeat on both sides 10 x daily if possible.
Glute Stretching:
Version 1:
- Start in a comfortable seated position and stretch your legs out in front of you.
- Bring your left leg across the right, placing your left foot on the floor and bending your left knee.
- Inhale and stretch your arms overhead, making your spine long.
- Exhale and twist to the left, letting your arms fall comfortably to your bent knee.
- Hold for 15 seconds.
- Untwist and repeat on the other side.
Version 2:
- Start by laying on your back.
- Cross your right leg over your left, placing your ankle on the opposite knee.
- Place your hands through the gap in your legs, holding onto the leg still in contact with the floor.
- Using your arms, pull both leg towards your chest, this should intensify the stretch
- Hold for 15 seconds.
- Repeat on the other side.
