Sciatica; What is it & why do we get it?
There is often a lot of confusion and fear associated with the term sciatica, but what do we really know about sciatica and why do we get it? Whilst I’d admit I wasn’t very creative with the title for this blog. The answers to these questions are often what people want to know. Whenever we get musculoskeletal pain, we simply want to know what is causing our pain and why we are getting it? Before delving into this blog, it is important to understand that musculoskeletal pain is not always clear cut and many factors (e.g. stress, lack of sleep, poor nutrition etc…) may also be the driving force behind our pain.
What is sciatica?
Sciatica is simply the ‘name given to pain caused by irritation of one or more of the sciatic nerve roots in the lower back’. ‘The sciatic nerve is a large nerve that starts in the buttock and travels into the leg. This nerve is formed by smaller nerves known as nerve roots that enter and exit the spine in the lower back. Irritation of these nerve roots can cause pain in the buttock, thigh, calf and foot’.
What are the symptoms of sciatica?
‘As well as pain travelling down the leg, individuals with sciatica can experience a burning pain, an electric shock type of pain and/or pins & needles. More unusual symptoms include a sensation of coldness and running water. Some people may also experience numbness or muscle weakness in the leg. This is because some nerves become irritated and send more signals, whereas in other cases some signals in the nerve can be blocked’. This is a basic explanation because let’s be honest there is some uncertainty and complex theoretical information surrounding the reasoning for nerve related pain in the spine.
What may sciatica feel like?
Now as someone who hasn’t experienced this type of pain I can’t really comment, but in this paragraph, I will elaborate and relay details from patient experiences of whom I have assessment and treated in the past. Now, some individuals had only experience just pain as part of their sciatica, whilst others had only experience muscle weakness and/or sensation changes in their leg. Some individuals had reported relatively mild symptoms, whilst others had reported severe symptoms that were disabling e.g. couldn’t walk or bend for a period of time.
Sciatic pain ranges from a dull ache sensation to a variety of different pain descriptions e.g. sharp, burning, shooting, or an electric shock sensation as mentioned earlier. I have often heard these descriptions of sciatic pain from a number of individuals. It is important to remember that sciatic pain is subjective, affecting people differently. However, what we do know is that people with sciatica related pain will often report pain following a typical pathway e.g. lower spine, buttock, thigh, calf, foot. Now, this is where I have got confused in the past. One person explained to me that at one specific time point, they got pain specifically in their buttock, but at another specific time point they reported pain that occurred along their sciatic nerve pathway. Therefore, it is important to remember that ‘sciatic pain can be highly variable and affect people in different ways‘.
What causes sciatica?
It is thought that anything which irritates the nerve root can cause sciatica. A common cause of ‘irritation’ is compression associated with intervertebral disc related changes in the spine. It is important to know that nerve roots are strong, robust and resilient structures that can recover over a period of time. However, in some cases nerve roots may become irritated by inflammation without any compression, and yes, this is still painful for those that have been affected by this change. Not all disc related changes will compress or irritate nerve roots.
Intervertebral discs separate bones of the spine, whilst also having a strong attachment to them. Therefore, let's just be clear intervertebral discs cannot ‘slip’. In fact, this is anatomically impossible and something that is often echoed by people with back pain. Another key point to mention is that pain is multifactorial and often influenced by factors such as reduced sleep, stress, poor nutrition and emotional wellbeing.
Who gets sciatica & how long does it last for?
Sciatica will often affect people of all ages but is most commonly seen in people aged 40-50 years of age. Prognosis varies from individual to individual whereby some people experience pain getting worst in the first few weeks, followed by their pain easing in the months to follow. It may even take some people a year or longer to fully recover from sciatica. This is because people adapt and cope with their pain in different ways.
How can Principle Physiotherapy help?
Principle physiotherapy can offer a range of management options, this includes advice, education, hands on treatments, self-management strategies, and individualised rehabilitation programmes utilising evidence-based research and gym-based facilities to help build confidence with functional movements again and thus, help restore wellbeing. We have skilled and qualified staff, all with different backgrounds to helping people overcome and manage their pain-related issues. All staff utilise a holistic-based approach to ensure that all assessments are thorough, therapy is optimised and ultimately, goals are achieved.
If you would like to gain more information about sciatica or want to know if you have sciatica based on the information from this blog, then please don’t hesitate to get in contact. We can arrange an appointment that suits your availability. We are following strict covid-19 government guidelines so be assured that your safety, health and wellbeing is our number one priority.
Oliver Curtis
Chartered Physiotherapist
Our details are as follows:
Contact – 07878679872
Email – info@principlephysiotherapy.co.uk
References:
Living Well With Pain. 2020. A Patient’s Simple Understanding Of Sciatica, Radicular
Pain And Radiculopathy – Living Well With Pain. [online] Available at:
<https://livingwellpain.net/a-patients-simple-understanding-of-sciatica-radicular-pain-
and-radiculopathy> [Accessed 30 October 2020].
Southtees.nhs.uk. 2020. Patient Information / Educational Resources – South Tees
Hospitals NHS Foundation Trust | South Tees Hospitals NHS Foundation Trust.
[online] Available at: <https://www.southtees.nhs.uk/services/back-pain-triage-and-
treat/patient-information-educational-resources/> [Accessed 30 October 2020].
