Sciatica

Sciatica, or pain down the back of the leg, is a common diagnosis presenting to our clinic and if you do a search on the internet for back pain, it is a common topic of interest as well. Do an internet search for ‘leg pain’ and you’ll get a multitude of hits with the title “sciatica”. Not to be mistaken with standard low back pain, a true sciatica will present with symptoms of pain down the back of the leg, paraesthesia (changes in sensation of the skin at the affected site), changes in reflexes and potential losses in muscle strength of the lower limb. It occurs when there is irritation of the sciatic nerve (which runs down the back of the leg) either in the leg or at the origin at the spine from which it originates (L4-S1). There are multiple causes of sciatica, ranging from degeneration of the spine, bulges of discs at the spine, inflammation of the nerve itself, infection, trauma, muscle spasm of the group of muscles it runs through (hamstrings, calf muscles, piriformis), and in rare cases a malignancy in the spine itself. A nasty condition to experience, it affects your ability to bend forwards, sit for long periods of time, and causes a loss of mobility in general. Prognosis for people with a ‘true’ sciatic are variable and it’s a condition that can often result in prolonged pain and limited function. There are a variety of studies that look at the benefits of exercise, manual therapy, Cognitive Behavioural Therapy, Steroids and other medications and as you can probably tell, the health profession is continuing to work towards the best treatment approach for sciatica. However, as with many conditions, the sooner you are seen, preferably during the acute phase before the 3 month period, the better the outcomes in the long term.

Stay well

Sam and Andy