Sciatica Pain And How To Overcome It
The Top 5 Reasons Why You May Be Having Back Pain and Leg Pain
Sciatica. You’ve heard the term from a family member, a colleague, a friend, or maybe even experienced it yourself. At face value, all the stories sound the same:
Severe back and leg pain
Burning, shooting, numbness, and tingling sensations.
Trouble bending, sitting, standing, and walking.
Why, if everyone’s stories sound the same, do the Googled movement ideas or medication suggestions not work? Well, the reality is that not all sciatica is created equally, and the source of back and leg pain is not always the same. This post will delve into the different reasons why you may be experiencing this kind of discomfort, and how physical therapy may be able to help you reduce and eliminate the pain.
Why is it called Sciatica?
One of the largest nerves in the body is termed the Sciatic Nerve, and it travels down the back of each leg. This nerve is responsible for supplying a large amount of “electricity” to the lower body, thereby explaining the infamous “Sciatica” diagnosis. Despite popular belief, it is not the only nerve in the lower body. There is a “switchboard” of nerves that leave the spine and form a few different nerves. One of these nerves is the Sciatic. Nerves can become injured or irritated at multiple points along their path, anywhere from where they start in the spine all the way to where they end in our fingers or toes. Keeping this in mind may assist in the understanding of why individuals' back and leg pain may present differently.
What can cause Sciatica?
What causes pain in the back and lower leg? There are at least 20 different causes of sciatica, but we will outline five of the most common in this article and explain how Summit Physical Therapy’s treatment options may be different for each one.
1. Lumbar Spine Disc Injury
A gel-like cushion structure called a disc is present between each of our vertebrae. There are varying levels of disc injury ranging from simple irritation of the disc tissue, all the way to injuries that lead to nerve compression. Pain is not a good way to gauge the severity of a disc injury, since the disc and the surrounding nerves are all very sensitive. This sensitivity can make pain levels much more severe than the level of damage that has occured. We can further separate disc injuries into new injuries and old injuries, which will help determine what will need to be done to assist in healing and return to your daily life.
New Disc Injury: A new disc injury can feel like you “threw out your back”, and may or may not produce immediate pain down the leg. This injury more likely than not improves on its own with natural healing, but can be helped along with therapist-guided repetitive stretches, mobility work, and strength for support. It can be a scary diagnosis due to the initially high pain levels. Great news for those suffering, nearly all cases have potential to fully resolve with specific exercises and a plan to allow for natural healing.
Old Disc Injury: Old disc injury pain may have begun many years ago, and may feel like you have injured the same area multiple times. This may be due to a muscle strength or control issue causing repetitive irritation of the disc tissue. Addressing the core, hips, and any weakness that may be present will help reduce consistent irritation, creating support to decrease pain levels.
2. Muscular Pain and Strain
There are a multitude of muscles surrounding your spine, all of which help you stand tall and move properly. Knots or tender points in these muscles (whether from weakness or overuse), can cause pain that radiates into the buttock and down the leg. Muscles in the low back pain pelvic region can also be strained with heavy movements and have a tendency to radiate pain to a wider area of pain than the low back in isolation. With increased strength and increased control of these muscles, the strain on this area can be reduced, thereby decreasing the pain you are feeling. Physical therapy can assist in the specific interventions needed to improve the strength and control in the right areas.
3. Spinal Stenosis and Arthritis
As we age, there are normal changes that occur at all of our joints, formally referred to as osteoarthritis. One example of these changes is called spinal stenosis. These changes may lead to reduction in space for your nerves to pass through. Despite changes in the joints, pain can be addressed by a combination of opening the space up with specific movement and taking the strain of the joints by improving hip strength. Some treatments can be as simple and easy as bending forward a few times. A physical therapist can assist you in determining what types of bending exercises and positioning can make a quick and significant impact on your pain.
4. Compression or Irritation of the Sciatic Nerve (or others!)
Although the lower back tends to get all of the attention, there are other places in the leg and pelvis where the sciatic nerve can become irritated. Though a less likely diagnosis, there may be instances of injury to the thigh or lower leg that lead to changes and irritation of a nerve. If it is an injury at the buttocks or back of the thigh, it is likely the sciatic nerve. Our expertise will allow us to determine what is most likely occurring in this type of situation and address the issue at its source.
5. Hip Arthritis
Another little known fact is that your hip joint may also be responsible for the pain you are feeling into your leg and back. As explained above, normal changes to a joint over time can lead to discomfort. In the case of the hip, pain can distribute to the back and also radiate in the same places that pain in the back may produce. When the hip is the cause of your back pain or sciatica, proper assessment is key in making sure you do not waste time treating the symptoms and not the cause of the issue.
How Can Summit Physical Therapy Help Alleviate Your Sciatica?
There are many ways that a physical exam can help determine the specific source of YOUR pain, even when the location of this pain is similar to many other cases. Just request an appointment with one of our physical therapists and we can have you come to our office for an initial consultation. Once a thorough examination is complete and your individual impairments have been identified, treatment will focus specifically on what is producing your discomfort. Whether it is reducing inflammation, reducing compression, taking off tension, or completing a series of repeated motions that decreases the area in which pain is felt, we will choose the option that best helps you.
If you are dealing with lower back and leg pain, we are here to help! Reach out and request an appointment to get started. You can also call our office at 908-589-9009 and our team will help schedule your appointment.
RESOURCES:
1- Radicular Back Pain
Authors: Alexander M. Dydyk1; Mohammad Zafeer Khan2; Paramvir Singh3.
2- Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021 Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopedic Physical Therapy of the American Physical Therapy Association
J Orthop Sports Phys Ther. 2021;51(11):CPG1-CPG60. doi:10.2519/jospt.2021.0304