Back Pain Specialist:
- Ross has been treating back pain since 2002 & has extensive experience working in some of the top pain clinics in Ireland.
- Ross’s passion & lifetime commitment to helping others who are suffering with back pain is based on his own personal experience & frustration in seeking help for the condition.
- Ross’s educational background has facilitated a considerable research focus on chronic back pain management & rehabilitation.
To book an appointment for Sciatica treatment call the Physio Clinic Naas & Newbridge now on:
(045) 874 682
What is Sciatica?
Sciatica is characterised by severe pain in the leg along the course of the sciatic nerve. The sciatic nerve is formed by the union of several nerve roots originating in the lower back (lumbar spine).
These nerve roots join to form the sciatic nerve which runs deep to the gluteal muscles at the pelvis and runs down the back of the thigh to the knee where it branches further into other nerves.
The sciatic nerve is the largest nerve in the body. Because of this nerve distribution, sciatica pain distribution varies from pain in the back of the buttock to right down to the sole of the foot. Irritation of the nerve can also give rise to numbness, weakness or pins & needles in the distribution of the nerve.
In some cases sciatica may appear with symptoms only in the heel, calf or foot with no associated leg or buttock symptoms.
Sciatica is commonly provided as a diagnosis in cases where practitioners are unsure of its cause; however, this does not indicate the source of the symptoms. Identifying the source of ‘sciatica’ is very important if it is to be managed appropriately.
What are the Causes of Sciatica?
There are many causes of sciatica including:
- Nerve root compression from disc herniation
- Compression of sciatic nerve outside the spine e.g. the buttock or pelvis
- Spinal stenosis (narrowing) due to degeneration
- Infection
- Diabetes or alcoholism
Other potential sources of sciatica described in the literature include irritation of the joints (facets) of the lumbar spine. Dysfunction of the pelvis (sacroiliac joint) is also thought to be a potential source of sciatica.
A disc herniation is a relatively common cause of sciatica. The most common age group in which disc herniations occur are 30-50 year olds; this is due to the level of spinal degeneration that has taken in this age group.
This degenerative process eventually leads to dehydration of the spinal discs thus there is a reduced incidence of disc herniation over the age of 50.
How Is Sciatica Diagnosed?
The diagnosis of sciatica is a clinical one based on presenting symptoms. While a diagnosis of sciatica points highlights the presence of pain, it does little to identify the source of such symptoms.
The goal of the physical examination is to differentiate between pain sources in the lumbar spine, pelvis, leg & foot. This will involve the use of specific orthopaedic tests, assessment of strength & sensation, & reflex testing of the lower limbs.
Your physiotherapist or chiropractor may wish to refer you for further examinations such as x-ray or MRI should the severity of symptoms not improve or if clinical tests warrant such an evaluation.
Sciatica Treatment
The treatment of sciatica will be guided by the source of the condition. The goal is to remove the pressure on the nerve that is giving rise to the symptoms. Symptoms of pressure on the sciatic nerve may include pain, tingling or pins & needles.
The initial focus will be on reduction of pain and swelling. Once this has been addressed then the goal will be to improve stability and strength of the supporting structures of the spine & pelvis. The goal of such an approach is to reduce the load on the painful structures by improving the strength and stability of the surrounding muscles of the lumbar spine and pelvis.
Your physiotherapist may assess the muscle recruitment pattern around your pelvis & trunk in order to identify abnormal muscle recruitment patterns that may be a driver of pain. Of course, as with all conditions, prevention of recurrence should be a key consideration in any rehabilitation programme.
Manipulation/Manual Therapy Research:
Treatment of the sacroiliac joint in patients with leg pain: a randomized-controlled trial.
PURPOSE:
The sacroiliac joint (SIJ) may be a cause of sciatica. The aim of this study was to assess which treatment is successful for SIJ-related back and leg pain.
METHODS:
Using a single-blinded randomised trial, we assessed the short-term therapeutic efficacy of physiotherapy, manual therapy, and intra-articular injection with local corticosteroids in the SIJ in 51 patients with SIJ-related leg pain. The effect of the treatment was evaluated after 6 and 12 weeks.
RESULTS:
Of the 51 patients, 25 (56 %) were successfully treated.
Physiotherapy was successful in 3 out of 15 patients (20 %),
Manual therapy in 13 of the 18 (72 %),
& intra-articular injection in 9 of 18 (50 %) patients (p = 0.01).
Manual therapy had a significantly better success rate than physiotherapy (p = 0.003).
CONCLUSION:
In this small single-blinded prospective study, manual therapy appeared to be the choice of treatment for patients with SIJ-related leg pain. A second choice of treatment to be considered is an intra-articular injection.
Surgery for Sciatica
If symptoms of leg weakness or numbness continue over a number of months without sign of improvement then a surgical assessment may be warranted. Surgery is also indicated where there are changes in bowel or bladder function or impaired sensation around the buttock region.
To book an appointment for Sciatica treatment call the Physio Clinic Naas & Newbridge now on:
(045) 874 682
or email us at info@physioclinic.ie[/vc_column_text][/vc_column][/vc_row]
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