What is sciatica?

Sciatica is defined as pain experienced in the distribution of the sciatic nerve, ie buttock and leg. It can vary from a mild nuisance- value pain, through to severe and debilitating pain with disruption of nerve function to the legs/bladder/bowel, requiring emergency surgery. “Sciatica” is a label, not a diagnosis. It does not define the severity, it does not explain why the pain is experienced and it does not define what structure is responsible for the pain. Hence, it does not help determine the treatment. Sciatica is by definition a referred pain, which means that a structure away from the region of pain experience is causing the pain.

What causes sciatica?

Sciatica can be caused by an inflamed or herniated intervertebral disc in the lower few segments of the spine, an inflamed joint or ligament, congenital or degenerative narrowing of the spinal canal, muscle spasm in the buttock. It can be the result of more sinister pathology such as an infection or tumour.

How do we examine sciatica?

The key to successful management of sciatica is to accurately diagnose the: Source of the pain – what structure is the pain emanating from, eg. disc, muscle etc. Cause of the pain – what mechanism is provoking the pain, eg. posture, degeneration, inflexibility, congenital features, occupational factors, multiple factors etc.

How do we treat sciatica?

Treatment should be specific the diagnosis; treat the cause not the symptoms. More often than not this is conservative. We offer a range of safe, effective, evidence-based modalities to address your problem. This requires a comprehensive examination of the spine, pelvis and hips including joint alignment, joint mobility, stabilising muscle function in the spine hips and pelvis, neural function and patterns of use at home/work/sport. If the problem is more severe or not likely to respond to conservative treatment, then surgery may be considered. Your physiotherapist can explain the surgery to you as well as rehabilitative exercises that are essential to make the most out of your investment in surgery.