The past few weeks have been very busy for me. The knees held up and I completed the Vitality 10k run on the 29th May raising money for the PDSA. With over 12000 runners it was very busy but great fun!
I’ve also been to a “lower back pain and sciatica” workshop where I learnt some new techniques and exercises. In this newsletter I’ve outlined how I would treat sciatica as it is a very common condition I see in clinic.
Sciatica is the term given to any sort of pain caused by irritation or compression of the sciatic nerve, most commonly due to a bulging or prolapsed disc. The sciatic nerve starts at the bottom of the spine and passes through your buttocks down the back of the leg, ending at your foot.
The pain from sciatica is usually felt in the buttocks and legs and symptoms can include a sharp shooting or burning pain, pins and needles, numbness and weakness in the affected leg.
All treatments begin with an assessment.
1.Assessment/examination: A detailed case history and thorough examination including assessment of the whole spine, pelvis and lower limbs is extremely important to establish why a particular disc has become symptomatic. It may be that the disc has sustained trauma, it could be degenerative or there may be a quirk in an individual’s anatomy or posture, which has placed undue strain on one particular disc. Establishing how the problem developed in the first place is key to knowing how to treat the condition and prevent it from re-occurring in the future.
Treatment will then involve a combination of soft tissue massage, mobilisations, manipulations, nerve flossing and exercises – depending on the clinical picture.
Further info given below but please do not attempt these yourself without advice.
2. Soft tissue massage Pain can cause our muscles to go into a reflex protective spasm – the muscles tighten up around the symptomatic disc to protect the area and prevent movement. A variety of soft tissue massage techniques can help relax these muscles to gently encourage movement allowing you to stay as mobile as possible (staying mobile is the best advice when suffering a disc injury!). Soft tissue massage also improves circulation and lymphatic flow and assists in the removal of metabolic waste to help speed up the healing process.
3. Mobilisations + Manipulations Spinal mobilisations and manipulations can be applied to abnormal vertebra with the goal of improving functionality, reducing nerve irritability and restoring range of motion in the spine thereby reducing any excess pressure on the intervertebral disc. Mobilisations to the spine, pelvis and hips also help to stretch the muscles and joints, with the goal of increasing the range of motion within those areas to ease the pressure on the lower back.
4. Sciatic Nerve Flossing Nerve flossing is a technique used to stretch and release the sciatic nerve when it becomes compressed or entrapped. Dysfunctions that irritate the sciatic nerve and surrounding tissues create an inflammatory process and scar tissue formation may result in adhesions in segments of the sciatic nerve. This creates a lot of discomfort when you move, as the scarred nerve doesn’t glide smoothly, and flossing is required to break down the scar tissue to improve mobility.
5. Stretching + Strengthening Exercises A specific rehabilitative stretching and strengthening exercise program is important to help support the pelvis and spine, keep the muscles in balance and improve overall mobility. Continuing these exercises even when the pain has gone is key to prevent reoccurrence of the problem.
These are just some examples of what I can do to help treat sciatica and lower back pain. The specifics of your treatment plan are particular to your pain, level of activity and overall health as well as individual tailored advice.
So if you’re suffering why not book in for an appointment today!