Can physiotherapy help sciatica?

Can physiotherapy help sciatica?

What is the sciatic nerve?

Comprising 5 paired nerve roots found in the lumbar spine, the sciatic nerve is the longest and largest nerve in the body, travelling down the buttocks all the way to the sole of the foot. The sciatic nerve plays a vital role in connecting the nervous system to the skin and muscles of the lower body.

What Is sciatica?

Sciatica refers to pain caused by irritation or compression to the sciatic nerve (otherwise known as sciatic neuralgia or sciatic neuropathy). The pain is often described as shooting or radiating, where the sensation travels down the leg along the affected nerve. Sciatica is often localised in only one side of the body, with pain ranging from mild to intense, and often follows certain movements such as heavy lifting, twisting or bending. You might hear medical professionals term sciatica as radiculopathy, which essentially refers to pain, numbness or weakness in the limbs caused by a nerve root problem along the spine. If the nerve issues are found in the neck, they commonly cause pain in the arms, and is termed cervical radiculopathy. Since sciatica affects the lower back, it is also known as lumbar radiculopathy.

Can physiotherapy help sciatica?

Sciatica affects 10 to 40 percent of the population. Risk factors include increasing age, being male, having a history of low back pain, smoking, obesity and engaging in physical activity involving the back muscles.

Sciatica is generally diagnosed by medical professionals through physical examination, with radiating pain in one leg and the presence of other neurological indicators of nerve root issues being chief determinants of the diagnosis.

Physical activity is often recommended for the conservative treatment of management of sciatica, with little evidence suggesting the effectiveness of medication in symptom relief. With proper treatment, sciatic pain generally improves within four to six weeks. Secondary symptoms such as weakness and numbness usually take longer to resolve.

If symptoms do not improve within that time frame, you probably have chronic sciatica: symptoms can last over six months, and advanced treatment is usually needed.

How can physiotherapy help sciatica?

Since there are many disorders that can cause sciatica, your physiotherapists’ first task is to determine the exact cause of the sciatic nerve interference. Once the cause is ascertained, the next course of treatment is to remove the pressure on the sciatic nerve, usually through a combination of trigger point therapy, massage therapy and spinal mobilisation. Thereafter, treatment will focus on strength recovery, so that the client can return to daily function and an improved quality of life. Here, exercises target hip mobility and glute activation, as weakness in these areas are often found to contribute to sciatica.

More importantly, to ensure sciatica does not recur, the physiotherapist will work with the client to identify potential issues with daily movement and to correct poor movement patterns, both of which are common contributors to sciatica.

Below are exercises that will help aid recovery. Please do not further delay treatment if you are suffering with sciatica – best results are achieved when symptoms are addressed early. Do contact our physios at City Osteopathy and Physiotherapy.

Exercises

Can physiotherapy help sciatica?

Piriformis stretch (standing)

1. Stand upright.

2. Lift affected leg, bend knee and cross over the unaffected knee.

3. Keeping the spine straight, lean forward to feel the stretch in the affected hip.

4. Use the hand on the affected side and push knee away from body to feel a deeper stretch.

Hold 20 seconds, repeat 3 sets.

Can physiotherapy help sciatica?

Piriformis stretch (lying)

1. Lie on back.

2. Lift affected leg, bend knee and cross over the unaffected knee.

3. With both hands, reach the unaffected leg and pull both legs toward chest.

4. Feel the stretch on the affected hip.

Hold 20 seconds, repeat 3 sets.

Can physiotherapy help sciatica?

Hip flexor stretch

1. Sit on a stool with affected leg behind and unaffected hip infront.

2. Slouch to keep spine slightly flexed (this prevents the back from arching).

3. Reach and grab onto affected leg as you pull the ankle towards body (remember to keep the spine slightly flexed).

4. If unable to reach leg, hoop a towel around the ankle to pull the leg towards you.

5. Feel the stretch at the front of the affected thigh.

Hold 20 seconds, repeat 3 sets.

Can physiotherapy help sciatica?

Butterfly (lying)

1. Lie on back.

2. Place the soles of feet together.

3. Tighten the core to prevent the lower back from arching.

4. Feel the stretch in the hip and groin.

5. Squeeze glutes together to feel more stretch in the hip and groin.

Hold 20 seconds, repeat 5 sets.

Can physiotherapy help sciatica?

Glute massage

1. Lie on the floor with the affected knee straight and unaffected knee bent.

2. Place a tennis ball/trigger ball/massage ball/peanut ball under the affected glute.

3. Using both hands and unaffected leg, bear weight on the ball.

4. Feel pressure over the affected glutes.

5. Move up and down, right and left and clockwise and anti-clockwise.

Continue for 2 mins.

Can physiotherapy help sciatica?

Bridge hip abduction

1. Lie on back with knees bent.

2. Position your feet, shoulder width apart.

3. Engage the core, tilt pelvis toward head and lift hips up.

4. Turn out the hip while maintaining a bridge.

5. Feel glutes and core activation.

10 repetitions, repeat 3 sets.

Can physiotherapy help sciatica?

Hip extension (4 point kneeling)

1. Start with hands and knees on the floor.

2. Straighten the affected leg diagonally away.

3. Extend affected hip while keeping core activated and knee straight.

4. Feel glutes and core activation.

10 repetitions, repeat 3 sets.

Can physiotherapy help sciatica?

Glute bridge

1. Lie on back with knees bent.

2. Position feet shoulder width apart.

3. Engage the core, tilt pelvis toward head and lift hips up.

4. Feel glutes activation at the top.

10 repetitions, repeat 3 sets.