Sciatica is a condition in which the patient experiences pain which may or may not be accompanied by paresthesias. This occurs in the distribution of sciatic nerve. The characteristics include radiating pain in one leg. Other findings of sciatica include parasthesia and also muscle weakness. The sciatic nerve consists L4 through S2 nerve root.
Causes of sciatica-
- Compression of the sciatic nerve structurally
- traumatic injury
- spinal stenosis
- Spinal mass or abscess
- Direct surgical trauma
- Faulty positioning during anaesthesia
- Dressings/ casts/ etc with too much pressure
Clinical Presentation of sciatica-
- Radicular pain
- Sensory impairment
- tingling/ burning / numbness
- Muscular weakness
conservative treatment includes exercise, manual therapy, and pain management
- Pharmacology: NSAIDs, muscle relaxants; corticosteroid injections.
- Surgical evaluation: for disc herniation, epidural hematoma, epidural abscess or tumour
- Physical therapy
Physical Therapy Management for sciatica-
- Patient Education- avoid prolonged sitting/standing, Regularly changing position, proper posture, squat instead of bend to lift.
- Exercise and manual therapy
- Conservative management is best for sciatica cases.
- Patients should understand importance of lifestyle modifications such as to lose weight, stop smoking, consume healthy diet, exercise regularly, maintain good posture, engage in physical therapy program, etc.
- Complete bed rest is not recommended. Moreover It should be limited along with activities of exercise and daily functioning. Excessive dependence on pharmacological agents is not recommended to avoid dependency.
- Core strengthening is essential to maintain balance between muscle strength.