Back pain & sciatica

Physiotherapy treatment has been shown to help with pain from sciatica by reducing inflammation and relieving muscle tension. The aim is to relieve the symptoms of sciatica so that you can get back to the activities you enjoy without pain. Our physiotherapists will work with you one-on-one to find out what’s causing your sciatica and how best to treat it. Physiotherapy treatment consists of non-invasive techniques to relieve muscle tension and promote healing.

What is Sciatica?

Sciatica is an umbrella term used to describe pain that travels down the back of the buttock and leg, as low down as the feet and toes. Pain is usually caused by an irritation to the sciatic nerve (typically at the level of your buttock), or the nerve roots in your lower back which gives rise to the sciatic nerve. There can also be symptoms such as altered sensation, tingling and muscle weakness.

How long does Sciatica last?

Most cases of sciatica resolve within 4-8 weeks with appropriate physiotherapy management. If symptoms are more severe and include numbness, tingling and associated muscle weakness, it may take longer.

Sciatica rarely requires surgery, however, in rare circumstances where there is severe nerve compromise, for example, altered sensation in the saddle region or altered bladder or bowel control, surgery may be indicated.

What are the causes of Sciatica?

Often, there is no moment of onset for sciatica and tends to develop over a period of time. A 2007 study found that a common cause of sciatica is having a physical job, such as manual labourers and truck drivers. Specifically, common causes include those who are required to bend their spine repeatedly which may expose them to a greater risk of developing sciatica.

What are the symptoms of Sciatica?

How is Sciatica diagnosed?

Sciatica is diagnosed by a cluster of findings in your history and physical assessment by your physiotherapist. Your therapist will carry out a number of physical tests to determine the origin of your sciatic pain, such as muscle strength tests, nerve mobility tests and lumbar range of motion tests.

We will also want to know if you’ve had an injury, fever, problems controlling your bowels or bladder, previous cancers and whether you’ve been losing weight without trying. The answers to these questions are important because if these symptoms are present, the cause of sciatica could be a serious condition, such as a bone fracture, infection or cancer. These are rare, however.

How can my Physiotherapy help me? 

1) Sciatica treatment in the early stages involves a strong focus on reducing your pain with manual therapy, dry needling, gentle nerve stretching, and spinal mobility work to reduce the sensitivity of the irritated nerve. This usually yields great relief and a significant reduction in symptoms in 1-4 visits.

2) Ensuring long term results and minimising the chance of your symptoms returning by completing a personalised rehabilitation plan. There’s a structured approach to ensuring we address sciatica properly (see the early, mid and late-stage exercises below). Getting you pain-free is our first priority, but it’s our attention to detail in helping you rehabilitate through the entire journey that ensures our results are unrivalled and your symptoms don’t return.

This involves strengthening exercises that target the muscles that support your lower back and buttock. This is vitally important, as it will contribute to your body being able to cope with the demands placed on it day to day, as well as any recreational activities you love to do. A robust long term management plan also involves targeted nerve mobility exercises to improve the movement of your affected nerves, as well as spinal mobility exercises to improve the movement of your spine.

3) Ensuring you have no lingering weakness that will affect your function and quality of life moving forward. With moderate to severe sciatica symptoms, once your pain resolves sometimes there’s often some leftover weakness that makes your usual tasks harder than they’d normally be. To get back to your normal self, this needs to be addressed. A thorough Physiotherapy assessment can help identify what’s lacking, and give you the knowledge to fix it.