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Sciatica is a common condition which is characterised by pain that radiates from the spine down the leg.
Using an analogy, sciatic pain can be like a toothache. It can be a nagging, constant pain with various levels of severity. Symptoms often get worse by prolonged periods of sitting down, such as longer car journeys, as this puts pressure on the lower back.
When you get an injury, you will often have inflammation as a result. In the case of sciatica, this inflammation is compressing the nerve root in the spine, causing the symptoms to occur.
To explain further, it’s helpful to think about the spinal anatomy when thinking about sciatica. Your lower back, or “lumbar” region, is made up of five vertebrae. These are labelled “L1” through to “L5” which sits at the bottom of your spine. In between these vertebrae are discs which act like shock absorbers to provide support and cushioning for your spine. It is usually the lowest vertebrae, L4 and L5, which are more likely to be overloaded and injured. Inflammation around these areas can cause compression to the nerve roots around the spine, which may lead to these sciatic symptoms.
As the main symptom is leg pain, a common part of the assessment will include a “straight leg lift”. The purpose is to compare one leg to the other, in terms of pain levels and the angle legs can be lifted in turn. The patient lies on their back and slowly lifts their unaffected leg into the air. There will be a point where this becomes uncomfortable, much like a typical hamstring stretch. This is then used as a benchmark to compare to the other side with the symptoms.
Part of the assessment may also include specific pressure on the sciatic nerve itself. For more severe cases, an MRI scan may be required to provide additional detail for the diagnosis.
Sciatica itself will get better over time. For an injury such as a disc prolapse, it can typically take 6-12 weeks to recover. However, if sciatica is severe or persisting, a consultant spinal surgeon may discuss surgical options with you.
The next step is to assess the daily activities that could be underlying causes and contributing factors of the pain. For instance, there could be something in your job or at home which is putting pressure on the nerve. In these cases, a plan will be worked out for how these can be avoided to help reduce the symptoms.
Other treatments include postural advice along with manual therapy, such as massage or spinal mobilisations, to try to calm down the affected nerve root. There are also particular exercises which can help, although care should be taken to avoid stretching. Nerves do not react well to aggressive stretching or compression, so your physiotherapist or consultant will recommend gentle exercises you can do to mobilise the nerve, without irritating it further.
For more severe cases, a specialist spinal consultant may recommend targeted spinal injections. If other options are not viable, then a specialist may explore surgical options with you although this will be discussed in consultations you have.
If you believe you are suffering with sciatica, then we have a team of experts with many years of experience who can help. Whether you would like to book a physiotherapy assessment, or a consultation with a spinal specialist, get in touch for a no-obligation discussion about your options.
We also have state-of-the-art equipment which we can use to help you with your recovery. For instance, the AlterG anti-gravity treadmill  creates a vacuum to effectively reduce your bodyweight on the treadmill, which in turn reduces the load on your spine. Similarly, the Hydro Physio aquatic treadmill  can also be used to complete exercises in a controlled environment, with warm water helping to relax muscles and reduce pain.
We also have Nordic Health spinal strengthening technology  which is specifically designed to help with your recovery from a spinal injury. The equipment is customisable and a member of the team will talk you through how to get the most from it. https://www.circlehealth.co.uk/rehabilitation/about-us/specialist-equipment/alter-g-weightless-rehabilitation  https://www.circlehealth.co.uk/rehabilitation/about-us/specialist-equipment/hydro-physio  https://www.circlehealth.co.uk/rehabilitation/about-us/specialist-equipment/david-machine