Sciatica is characterised by a range of symptoms that typically affect one side of the body, starting from the lower back and radiating down through the buttock, thigh, and leg. The hallmark symptom is a sharp, shooting, or burning pain along the sciatic nerve pathway, which may worsen with movements such as sitting, standing, or sneezing. Many individuals also experience tingling sensations, numbness, or a pins-and-needles feeling in the leg or foot. In more severe cases, muscle weakness may develop, making it difficult to walk, climb stairs, or lift the foot, a condition known as foot drop. Sciatica can significantly limit mobility, reduce range of motion, and disrupt daily activities, particularly when symptoms worsen at night or with prolonged inactivity.

Carrying out a full assessment for sciatica is crucial to accurately diagnose the condition, identify its underlying cause, and ensure appropriate treatment. Sciatica can stem from various issues, such as herniated discs, spinal stenosis, or piriformis syndrome, and a comprehensive evaluation helps pinpoint the exact source of nerve irritation. Additionally, a thorough assessment can rule out serious conditions like cauda equina syndrome or other non-sciatica-related causes of pain, avoiding misdiagnosis and ineffective treatments. By evaluating symptoms, range of motion, nerve function, and overall physical health, healthcare providers can develop personalised treatment plans, monitor progress, and address contributing factors like poor posture or muscle weakness. This not only facilitates effective recovery but also minimises the risk of recurrence, ensuring safer and more targeted care for patients. These checks include:

1. Medical History and Physical Exam: A health care professional will first gather information about the patient’s symptoms, recent injuries, and overall health. They may conduct a physical exam to assess pain intensity, location, and range of motion.
2. Neurological Exam: This helps identify any changes in sensation, reflexes, or muscle strength in the affected leg. The health care professional may perform specific manoeuvres, such as the straight leg raise test, which can trigger sciatica pain and help identify nerve compression.
3. Imaging Tests: X-Rays: To check for bone concerns like fractures or arthritis. MRI: To visualise soft tissues, including herniated discs or nerve compression. CT scans: Sometimes used as an alternative to MRI. Electromyography (EMG): Measures electrical activity in muscles to assess nerve damage.

Treatment for sciatica aims to reduce pain and restore function, and options range from conservative management to surgical intervention, depending on the severity.

Conservative Treatments

• Rest and Activity Modification: Short-term rest may relieve pain, but prolonged bed rest is usually discouraged. It’s important to stay active but avoid activities that worsen symptoms.
• Physiotherapy and Osteopathy: Targeted exercises improve strength and flexibility in the lower back, pelvis, and abdominal muscles, which can relieve pressure on the sciatic nerve. Manual therapy improves spinal alignment and reduces nerve compression. Set exercise programmes promote healthy movement of the sciatic nerve through surrounding tissues.
• Medications: Over-the-counter pain medication can provide relief. Muscle relaxants or anti-inflammatories may also be prescribed as needed.
• Hot and Cold Therapy: Applying heat can ease muscle tightness, while cold packs can reduce inflammation. Alternating between the two may help relieve pain.

Invasive Treatments

• Corticosteroid Injections: In cases of persistent pain, corticosteroid injections can reduce inflammation around the affected nerve. The relief is typically temporary but can be effective for acute flare-ups.
• Nerve Block Injections: A nerve block targets pain signals from the affected nerve root, providing temporary relief and allowing the patient to engage in rehabilitation exercises more comfortably.

If you are struggling with sciatica or have any questions regarding this, call our Centre on 01386 792126.

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