Sciatica

WHAT IS SCIATICA?

Sciatica is a term used to describe pain and nerve symptoms that are felt in the lower limb, typically along the path of the sciatic nerve – from the hip region and down the back of the leg to the foot.

The sciatic nerve originates in the lower back and is formed by nerve roots from the lower spine, between levels L4 and S3. It is the thickest peripheral nerve in the body, being approximately 2cm wide. Compression and irritation of the sciatic nerve, or nerve roots, can cause a variety of symptoms which can become chronic in many cases.

SYMPTOMS

Patients often describe pain as either radiating, burning, stabbing or aching, from the region of the buttock through to the foot and toes. Neurological symptoms can also be common, with tingling, pins & needles and numbness being the most frequently reported.

⚠️ Burning pain
⚠️ Aching pain
⚠️ Tension/tightness
⚠️ Tingling

⚠️ Pins & Needles
⚠️ Numbness
⚠️ Weakness (advanced cases)

CAUSES

Sciatica can be caused by spinal pathology, when a nerve root becomes compressed or irritated to the point of generating symptoms. This can be due to an acute disc injury, or advanced degenerative changes occurring over a longer period of time.

🔱 Acute disc herniation

🔱 Degenerative disc disease

🔱 Osteoarthritis; bone spurs

🔱 Ligament thickening

Sciatica and sciatic-like symptoms can also have causes outside the spine, commonly by fibrous entrapment of the sciatic nerve. Entrapment of the nerve can develop at various locations throughout the hip, thigh and lower leg, causing chronic symptoms that may persist with or without the presence of a disc injury and/or degeneration.

🔱 Sciatic Nerve Entrapment

For more info, please see this article 👇

Sciatic Nerve Entrapment: A real pain in the butt

DIAGNOSIS

A diagnosis of “sciatica” lacks clinical detail and only tells us that there are symptoms, likely to be in either one or both legs. Therefore, “sciatica” could be considered a label, but not as a robust clinical diagnosis.

When a patient reports sciatica, it is important to determine whether the symptoms are generated by spinal pathology, or external to the spine (such as peripheral nerve entrapment) – or a combination of the two!

In most cases, clinical evaluation is sufficient to determine the diagnosis.

✅ Full detailed history
✅ Functional testing
✅ Orthopedic testing
✅ Hands-on palpation
✅ Neurological examination

👉 Imaging (MRI/CT/X-ray) may be necessary to determine the full diagnosis in some cases.

TREATMENT

Most cases of sciatica can be treated non-surgically, but this is highly dependent on the diagnosis. In our office, we primarily use hands-on soft tissue techniques and Shockwave therapy to treat the diagnosis and reduce symptoms.

▶️ Hands-on soft tissue treatment
▶️ Shockwave therapy
▶️ Instrument-assisted soft tissue treatment
▶️ Rehabilitation exercises

👉 Referral to a neurologist/neurosurgeon may be required to achieve the best outcome in some advanced cases.

If you, or anyone that you know is suffering with sciatica that won’t go away despite everything you’ve tried so far, please consider scheduling an Initial Consultation (link below on this page).

Dr. Christopher Aysom, Principal Clinician
BChiroSc, MChiro (Chiropractor)
Apex Soft Tissue & Spine
Pymble, NSW, Australia
https://apexsofttissue.com.au

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