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Sciatica Treatment by Physiotherapists

Physiotherapy Treatment of Sciatica by Jonathan Blood Smyth Sciatica results from a structure impinging on a lumbar nerve root, causing compression and/or inflammation enough to cause neurological changes in the skin, reflexes and muscles served by the affected nerve. Not a common syndrome, it is estimated that 3-5% of the population suffer this kind of problem at some time. It affects men and women equally with men most susceptible in their forties and women in their fifties.?? Up to a quarter have symptoms which last more than six weeks and referral to physiotherapists for acute management is routine.


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 A thorough history performed by the physio will uncover any red flags, an indication of a possibly serious underlying medical condition responsible for the pain. Loss of weight or appetite, severe pain at night, a history of cancer, unwellness or fever, bowel or bladder control difficulties, young or older patients, all these things ring warning bells and the physio will refer the patient on to a medical specialist for evaluation. The location, nature and response to activities and postures of the pain will be noted by the physiotherapist.

The physiotherapist begins with postural observation of the patient which can show an inability to stand up or a thoracic shift to one side. Spinal movements are performed and the pattern of movement limitation noted, with a full neurological examination of the lower limbs. The physio is looking for deficits in muscle power, reflexes or feeling which are related to the specific nerve root involved. The straight leg raise may be performed to check the stretch reaction of the spinal nerve.

Disc prolapse can result in the internal nuclear material being extruded past the outer disc wall, physically compressing the nerve root which runs nearby. The nuclear material is also chemically irritating to the nerve structure and these irritants make the nerve and nearby structures swell, partly blocking the local circulation and the nerve's message transmission. Disc prolapse is typically the cause of proper sciatica but the size of the prolapse is not closely related to the amount of pain the person suffers.

The great forces which we impose on the low back mean the lumbar intervertebral discs suffer structural changes and prolapses. Many activities involve a significant level of leverage, such as flexing over, performing movements in an upright position and lifting with the arms away from the body. This greatly magnifies the forces on the discs and due to their fluid mechanics they suffer 3-5 times the loads on the skeleton. This can cause the disc walls to degenerate, giving weak areas and predisposing to prolapse at some time. We have omitted irrelevant information from this composition on Sciatica as we though that unnecessary information may make the reader bored of reading the composition.

 
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Physiotherapists use a variety of therapies to treat sciatica, with McKenzie technique being a mainstream technique for discogenic pains. Mobilisation and manipulation techniques, core stability work, myofascial release, specific exercises, manual techniques, soft tissue work and massage, analgesia, patient education, rest, the best position to relieve extreme sciatica pain and advice are all used as treatments. Most sufferers settle without investigation or surgery and a long term exercise programme is useful once the problem has settled. We take pride in saying that this article on Sciatica is like a jewel of our articles. This article has been accepted by the general public as a most informative article on Sciatica.

The McKenzie technique works on pain centralisation, the tendency for pain to move towards the back from the legs, suggesting a disc problem, and many physios use this technique. Pain in the front of the thigh and over the knee can be referred from the hip joint, so the physiotherapist will assess the lower limb joints to check the diagnosis. A thorough examination informs the physiotherapist of the likely diagnosis and how they might treat the syndrome, or that the patient needs to be referred to a medical practitioner for a consultation and investigation. Having been given the assignment of writing an interesting presentation on Sciatica, this is what we came up with. Just hope you find it interesting too!

About the Author:

Jonathan Blood Smyth is a Superintendent Physiotherapist at an NHS hospital in the South-West of the UK. He specialises in orthopaedic conditions and looking after joint replacements as well as managing chronic pain. Visit the website he edits if you are looking for physiotherapists in Manchester.


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SCIATICA, Gridhrasi in Ayurveda, is a Vata roga, characterized by Sharp Shocking pain radiating from the Hip unto Thigh, Calf or the Toes in one or both the Legs. Numbness, Weakness, Tingling sensation & Discomfort along the path of the Sciatic Nerve are the results of Compression, Irritation & Inflammation of the Sciatic Nerve. The most common causes are Lumbar herniated disc, Lumbar...


What are the causes behind the pain of sciatica? Sciatica is usually associated with compression of the sciatic nerve due to a slipped or a herniated disc. A degenerative disc disease is a condition that is brought about by the ageing process. The sciatic nerve is sometimes pinched by the piriformis muscle that is located deep in the buttocks. Sciatic pain can also be caused by conditions...


So you have been diagnosed with sciatica and even though your doctor explained to you about the condition, you have come looking for a bit more information on sciatica. Lets start with the basic question on most peoples mind, what is sciatica? The general term used for pain being felt along the sciatic nerve is sciatica. This pain is usually described by patients as a sharp...


Many people think of sciatica, symptoms of which include pain down the leg, some numbness and weakness of the limbs as just another case of lower back pain and believe that with sufficient rest, the pain will go away. However, sciatica is a little more serious than that. Occasionally, the sciatic nerve roots - which start at the base of the spine and stretch all the way to the feet through the...


Is your sciatica pain common to herniated disc? If so, how do you get pain relief now? There certainly are a lot of different things that can go wrong with our backs. One of the worst problems that we can have, however, is if we have a herniated disc, especially if it is irritating the sciatic nerve. A herniated disc occurs whenever the padding that exists between the individual vertebrae...


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