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Common Injuries and Treatments

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Sciatica


What is sciatica?

Sciatica is a term that describes a group of symptoms caused by inflammation of the sciatic nerve that travels down back of the leg.  The symptoms are often described as burning, aching, numb, and/or tingling.

What causes injuries to this tissue?

Sciatica is most commonly caused by a compression of nerve tissue in the low back or buttock.  The most common cause of this nerve pressure is from an intervertebral disc bulge (which is the spongy tissue between the bones of the low back) closing down the small spaces that the nerve travels through as it exits the spine. Many individuals label any leg symptoms such as these as sciatica, when in reality there are several different nerves that can cause similar symptoms. When the sciatic nerve is involved the symptoms typically include outside and back of leg pain, numbness and tingling. Similar symptoms in other parts of the leg could be caused by involvement of  other nerves. If the nerve pressure causes both sensation (the person feels tingling or numbness) and motor (the person may have weakness or difficulty with daily tasks) issues it could be labeled as a radiculopathy. In rare cases, the sciatic nerve in pinched by an abnormal piriformis muscle anatomy and is caused Piriformis Syndrome

What is the best treatment approach?

Thorough evaluation is key to establishing the underlying cause of sciatica.  Physical therapist are great at identifying the cause of sciatic symptoms.  Primary care doctors, orthopedists (bone and muscle doctors), neurologists (nerve doctors) and physiatrists (rehabilitation doctors) can be involved in diagnosing sciatica too.  In very severe cases that do not respond to conservative measures, medications, injections and even surgery can be part of the treatment plan.  

What will the role of physical therapy be in this process?

Physical therapy is often the first line of defense in treating sciatica.  By first identifying where the nerve pressure is coming from, PTs can help with decreasing the  initial inflammation using soft tissue and joint mobilization techniques to increase flexibility.  Nerve glides can help to release the compressed nerve tissue and gently stretching and strengthening can work to create stability.

Will other services be helpful in taking care of this?

Underlying muscle tightness and soft tissue restrictions that are found to be related to sciatica may be helped by massage therapy work.  Acupuncture can also be of assistance with the pain associated with these conditions.  Training to return to specific life tasks or sports can be initiated by physical therapists and progressed by personal trainers.  After your initial physical therapy evaluation, your physical therapist will help to determine if these services may be helpful.

Need More?

If you have more clinical questions about this condition, please click here to email our Director of Clinical Operations, Jessica Douglas, MSPT, OCS, or you can get more information by searching our blog.

If you'd like a complimentary injury screen with one of our licensed physical therapists to discuss your condition, please contact us.

If you're ready to make an appointment for any of our services, please contact us.

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