Sciatica – a pain in the butt but what causes it and what can you do about it?

The term “Sciatica” is used to describe any pain in the legs or buttocks which is being caused by irritation of the nerve that supplies those areas; the sciatic nerve. The sciatic nerve delivers messages from the legs to the brain via the spinal cord. When there’s an irritation of the nerve, it can send pain messages relating to any part of the leg that it spreads to. For example, the irritation might be where the nerve originates in the lower back but the pain can be in your back, buttock, calf, or all of those areas. This is what makes sciatica a complex issue to diagnose because the pain is not always where the problem is.

 

Causes of Sciatica

There are many possible causes of sciatica including:

·       Disc herniation in the lumbar spine pressing on a sciatic nerve root

·       Stenosis – narrowing of the spine

·       Spondylosis – spinal osteoarthritis (wear and tear)

·       Nerve entrapment from a muscle in the buttocks

·       Trauma such as hamstrings tears

·       Infection

·       Blood vessels – particularly during pregnancy

The most common cause is a disc herniation which is a bulging of one or more of the discs in the spine, often due to sudden trauma or degenerative changes, which then presses onto the nerve root in the spine and alerts the body with a sharp pain signal. This is often extremely painful and worrying for the person but most herniations will subside with time with a full recovery expected in the majority of cases. In fact, researchers often find disc herniations in people with no symptoms at all.

 

Symptoms of Sciatica

The most common symptoms of sciatica are:

·       Pain in the low back, buttock, leg or foot – it can be all of these areas.

·       Numbness

·       Weakness

·       Tingling in the leg and foot

·       Limping while walking

·       Swelling in the leg

 

What Can Be Done About Sciatica?

The first thing to do if you have any of the above symptoms is to book yourself in for an assessment with a reputable physiotherapist. A thorough assessment will help to ascertain the cause of your symptoms and rule out any sinister pathologies. An important pathology to rule out is Cauda Equina Syndrome, in which the nerves in the base of the spine are being compressed, often causing disturbances to walking, toileting and sensation around the crotch region. Once sciatica has been diagnosed, it’s important to properly manage each stage of the recovery process. Initially, it’s vital that you gain better control of your symptoms to improve your comfort and function as much as possible. This may involve treatment, rest from aggravating activities, pain relief and light exercises to maintain your mobility. As your symptoms settle, the exercises should progress into strengthening and stability training in order to regain any strength lost during the injury. Then it’s important to prepare the body for a full return to normal function – whether that be gardening, walking or competitive sports – and put in place a plan to help prevent the symptoms of sciatica from recurring in the future.

Having sciatica can be a stressful and lonely experience. It can result in a reduction in exercise, socialising and can cause someone to take time off work – sometimes for extended periods. It’s a complex issue which can present in a variety of ways but can be well managed with the right guidance from a good physiotherapist.

 

If you wish to see an experienced physiotherapist about your sciatica symptoms, please give us a call or book yourself in using our online booking feature here: https://spires-physiotherapy.selectandbook.com/

Testimonials

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Jamal

Jamal
Ofori-Adu

BSc MCSP HCPC
West Hampstead Clinic.

Jamal is a Chartered Physiotherapist with a specialist clinical interest in musculoskeletal and sports injuries. He has worked in various clinics and led teams within the NHS and private practice. Along the way, he has honed his skills in the assessment and management of back pain, shoulder injuries and lower limb injuries. He combines his extensive experience with a passion for strength and conditioning, along with current research evidence, to inform his clinical decision making. He has a wealth of physiotherapy knowledge and he’s able to impart this in a pragmatic and honest fashion. He enjoys being active, plays football at semi-professional level and also enjoys creative arts, music and travelling. Jamal currently works in our West Hampstead clinic.

Dr Gurhan

Dr Gurhan
Kayihan

BSc MSc PhD MCSP HCPC
Didcot and Oxford clinics

Gurhan is a Chartered Physiotherapist and Sport Scientist with extensive experience in elite sport, the NHS and within the academic sector. After qualifying as a physiotherapist in 2003, he went on to obtain a masters degree before completing his PhD in Sport and Health Science in 2012. Alongside working within musculoskeletal clinics, he has worked internationally with the Turkish National Amputee Football team, lectured within universities and has conducted numerous research studies looking into exercise and lower back pain among other subjects. Gurhan’s research background enables him to utilise current scientific evidence as well his broad clinical knowledge to help people manage persistent pain and recover from acute injuries. When he isn’t working in the clinics or consulting for scientific journals, he likes to spend time with his family, hiking, doing martial arts and collecting old coins. Gurhan currently works in our Didcot and Oxford clinics.
Andreas

Andreas
Georgoulas

BSc MSc MCSP HCPC
Oxford Clinic

Andreas is a Chartered Physiotherapist and Kinesiotherapy specialist with extensive experience in private practice and elite sport. He has over a decade of experience working with professional athletes including track athletes, basketball players and the Olympic Rhythmic Gymnastics Ensemble. He is particularly proud of his work with the Greece National Athletics Elite Marathon Team. As a result, Andreas has developed expert sports injury rehabilitation skills alongside a wide range of treatment modalities. Outside of elite sports, he also has experience in post-operative rehabilitation, musculoskeletal disorders and elderly rehabilitation. Having completed his undergraduate training at Queen Margaret University, he then completed a masters degree in Musculoskeletal Rehabilitation in 2022. In his spare time, he enjoys athletics, basketball, cross fit and paint balling. Andreas currently works in our Oxford clinic.

Adelina Florea

Adelina
Florea

BSc MSc MCSP HCPC
Oxford Clinic

Adelina is a Chartered Physiotherapist with a wealth of private practice experience covering a range of specialties including musculoskeletal, cardiovascular and post-operative recovery. Alongside her rehabilitation knowledge, she deploys an array of manual therapy techniques. Adelina likes to combine her passion for scientific research with a person centred approach and draws upon her elite sports experience when devising exercise programmes for patients. To build on her undergraduate physiotherapy degree, she completed a masters degree in Implants, Prostheses and Biomechanics in 2016. Adelina has become a very popular member of our team among our patients and the other team members and her diary is often booked up a week in advance. Outside of work, she enjoys reading, writing, hiking and gardening. Adelina currently works at our Oxford clinic.

Goals

Once you have a working diagnosis for your injury, we’ll guide you through a staged rehabilitation plan which is targeted towards your exercise goals. Whether you want to return to running, weight-lifting or gardening, your rehabilitation plan will reflect this and your physiotherapist will always keep your goals in mind when treating you. Rather than just treating your symptoms, our holistic approach will get you back to your best, but even fitter and more resilient than before. That’s how we keep you doing what you love doing without re-injuring yourself.

Time

You won’t be in and out of the door within half an hour. We allocate 65 minutes for every appointment. Most initial appointments last 55-60 minutes and follow-up sessions tend to take-up 45-50 minutes. This allows your physiotherapist plenty of time to focus on you, build a tailor made plan and write-up your notes without encroaching on your face-to-face time.

Ethos

We are committed to providing evidence based physiotherapy with the aim of demystifying the world of sports injuries and therapy. We understand that you’ve probably been through the mill with multiple therapists using all sorts of electrical gadgets and gizmos, so we won’t overcomplicate your recovery with modalities that aren’t proven to work. What we will do is take a pragmatic approach, using our extensive clinical experience alongside the best available scientific evidence to treat you effectively and get you back to your favourite sports or activities.

Evidence

We are committed to providing evidence based physiotherapy with the aim of demystifying the world of sports injuries and therapy. We understand that you’ve probably been through the mill with multiple therapists using all sorts of electrical gadgets and gizmos, so we won’t overcomplicate your recovery with modalities that aren’t proven to work. What we will do is take a pragmatic approach, using our extensive clinical experience alongside the best available scientific evidence to treat you effectively and get you back to your favourite sports or activities.