You have a burning sensation in your lower leg, buttocks, and back. Sitting or standing for too long triggers this pain that ranges in severity. You just cannot seem to get rid of the sensation, and its keeping you from enjoying your daily routine or even participating in your occupation. If this sounds familiar, you could be experiencing sciatica. Sciatica pain is debilitating and incapacitating in certain cases. This injury refers to the leg pain one experiences after a mild or traumatic injury to the back, and directly relates to the large sciatic nerve that travels down the back of each leg. The nature of this nerve is naturally excitatory, and when overstimulated, it can create a response that leaves the patient with a feeling that leaves them bed-ridden until the pain subsides. It is important to treat not only the pain itself, but the injury causing the stimulation.
The sciatic nerve originates in the lumbar spine (lower back), which makes it a common target for injuries coming from weight-bearing, overuse, and traumatic injuries. Some of the causes include:
- Herniated Discs
- Bone Spurs
- Degenerative Disc Disease
- Spinal Stenosis
- Stress Fractures in the Vertebrae
- Piriformis Syndrome
Signs and Symptoms
- Pain usually affects one side in particular
- The pain starts in the lower back and travels to the buttock and lower leg
- Tingling in the feet and toes
- Pain that feels better when the patient lies down or walks
- Pain worsens when the patient sits or stands for too long
- Burning sensation
- Numbness or tingling
- Weakness when trying to move the affected foot and leg
- Lower muscular back pain
- Sitting to standing
Certain situations may increase the likelihood of sciatica pain.
- Obesity increases the stress on your spine, and can trigger sciatica pain
- Occupations that rely heavily on seated positions or weight-bearing positions could contribute
- Diabetes impacts nerve function, and may increase your risk of nerve damage
- Aging communities are impacted by sciatica due to the deterioration of discs and increase in the amount of bone spurs and spine-changes
Lumbar and Sciatic Nerve Anatomy
The spine is broken into segments, with the lumbar region consisting of 5 segments (L1-L5). In this area, the spine takes a slight curvature inward in order to bare the weight of the upper body. In between the vertebrae are the discs that contain the shock-absorbing fluid to reduce impact throughout the day, and the narrow canal in the center of the vertebrae houses the spinal cord. From the spinal cord, the major and minor nerves originate to innervate the rest of the body. The sciatic nerve, the largest and longest single nerve in the human body, originates in several of the lumbar vertebrae, and unites as it travels down the back and legs.
If you want a more in-depth anatomy of the lumbar spine, check out this link.
How Can You Treat Some of the Symptoms?
Some of the remedies to abate the symptoms are readily available in your very own household. Medical professionals everywhere encourage patients to implement the RICE method. Rice stands for:
- Rest – Limit or completely stop the activity that aggravates the back pain, such as carrying heavy loads at the gym or sitting for too long at work.
- Ice – Without putting ice directly on the skin, apply a cold pack for approximately 20 minutes (your physical therapist may recommend heat dependent on your individual circumstances; we ask you are cognizant of this).
- Compression – There are pressure braces that are specific to the back that assist with weight-support and posture. They do not necessarily compress the area in this case.
- Elevate – Does not apply for this injury, but do make sure that when you ice/heat/stimulate that you are comfortable and keeping the back in a neutral position that does not contribute to the pain (such as on your back).
NSAIDS, or non-steroidal anti-inflammatory drugs such as ibuprofen, can also provide short-term pain relief. We encourage you to receive an assessment from the physical therapist if the pain continues or increases in intensity. Other drugs that your doctor may prescribe under close watch and guidance include:
- Muscle relaxers
- Various others; please consult your primary physician
There are several other treatment methods that are potentially beneficial to the individual:
- Physical Therapy: They provide a thorough evaluation, dictate an exercise and stretching plan, and use modalities such as Electrical Stimulation and Ultrasound to decrease the pain. They can also professionally apply the Kinesio Tape and focus on your form and how it relates to your injury.
- Check out this video for a stretch to help relieve sciatica pain
- Steroid injections: This is usually done by a specialized spine doctor. They inject the area with an anti-inflammatory medication that can help treat and limit the pain.
- Surgery: The major reasons for surgery include significant muscle weakness, loss of bowel or bladder control, or pain that refuses to subside with physical therapy. Consult with your Physical Therapist and Primary Physician about this route.
Mid-County Physical Therapy Can Help You
During your one-on-one evaluation with the skilled therapist at Mid-County Physical Therapy, they will get to know you and your physical habits to help establish a foundation for your treatment. They will monitor and document your range of motion, techniques, and current pain-level to get a better idea of what they can do for your improvement. Before you receive treatment, it can also be beneficial to document some things such as:
- What movements cause it?
- When does it begin during activity?
- How long does it last?
- Have your home remedies stopped working?
- Do you want to maintain or improve your current fitness level?
- What are your goals?
Keeping track of this information can be essential for both you and your physical therapist.
Mid-County Physical Therapy also offers a wide variety of treatments to treat and heal your pain. Your condition could improve with a strengthening plan, which the therapist constructs based off of your individual experience. The clinic’s open-plan gym includes equipment to suit your strengthening needs while our therapists and technicians monitor to encourage proper form and maximum pain relief.
If the therapist determines you may need technique retraining, they will create a personal plan to work individually with you on form and techniques. Our clinic is also proud to offer dry-needling, kinesio taping, and even the BioQPulse. Call or contact us today to learn more about our treatment plans.