By Duke Autret
Many, if not most people will have heard of, or may even have experienced sciatic pain or sciatica, but what is it exactly? Let’s explore.
Sciatica is a term that gets thrown around alot but the fact is that it’s quite a vague term which is used simply to describe any condition where the symptoms involve pain running from the lower back down either one or both legs (potentially all the way down to the foot). Pain types can be sharp, shocking, tingly, numb, cause pins and needles, or cause pinching or catching sensations on movements.
So in fact Sciatica describes not one single condition, but rather a set of symptoms, and that these symptoms that we call Sciatica can be the result of a number of different mechanisms or conditions.
To be more precise, Sciatic refers to the name of the nerves which branch out from origins in the lower spine/back and then splits into two Sciatic nerves - one for each leg, and thus innervates the muscles and structures of the legs.
However this nerve can become vulnerable to irritation by pressure bearing on it from other structures, when this happens the experience is Sciatica!
As mentioned before there can be a variety of reasons for this impingement on the Sciatic nerves and some examples can include pressure from a tight Piriformis muscle (which the sciatic nerve passes directly through or beneath), pressure from an Intervertebral Disc bulge/herniation of the lumbar spine (lower back), Stenosis which is the narrowing of the spinal canal, Spondylolisthesis which is the slipping of one vertebrae over the next and that can pinch the sciatic nerve, or Spondylosis, an arthritic joint degeneration at the lumbar vertebrae which may cause inflammation and subsequent pressure and irritation from that.
As we can see, there are many ways in which the sciatic nerve can become impacted and the end result is the same experience and symptoms we call ‘Sciatica’. Some of these situations sound scary, but the majority of the time it is easy to get the pain under control while working with an experienced Myotherapist who can help guide you or refer you on if your condition is particularly acute or severe.
Since the irritation that occurs to the Sciatic nerve is to do with some or other kind of pressure, then the priority for treatment becomes to create more space for the nerve to be free, as nerves also need to be able to slide and move with the rest of the body.
Importantly, the treatment we use will be dependent on which of the various mechanisms are at play, but commonly any technique employed will be with the aim of creating more space for that nerve, and most often will involves treating the muscles of the lower back, pelvis, hips, glutes and back of the thighs and maybe even calves. Some of these techniques can include hands on options like remedial massage and myofascial release, or helpful nerve gliding movements that can help reduce the sensitivity of those nerves.
And in situations where the symptoms are very acute, fresh and severe often Myofascial Dry Needling is a go-to in order to take the edge off and tone everything right down without adding any more undue pressure to the nerve/system.
Myotherapists can also provide joint mobilisations to aid in better mobility of the lower back and hips. Mobilisations vary from manipulations - we won't be "cracking your bones", but gently encouraging rhythmic movement to return to your joints without any high velocity cracks or crunches.
From here we would look at tailored exercises for your situation which could simply be stretches for a few key tight muscles to a full program to help build stability around the spine and support the structure for healthy nerve function.
Some common exercises you might try could be deep abdominal work, diaphragm ‘weight-lifting’, the sphinx, Piriformis stretches, and Glute and Adductor strengthening.
Our practitioners will demonstrate these types of exercises and how to safely do them while you're experiencing sciatica, and we can assist you in progressing them as preventative care exercises once the intensity of your pain has eased.
If you or anyone you know is currently suffering with Sciatic pain, please come and see us, we are here to help. Just call or leave a message with us at the Simple Wellness Myotherapy clinic here in Rowville, or alternatively you can see our booking schedule and make an appointment yourself for a time that best suits.
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