Jesse Lewis, PT, DPT, OCS
Chances are you either have had sciatica or know someone who has said they have had sciatica. There are two reasons for this. First, it’s a very common condition that a lot of people have throughout their life. Second, it’s one of the most confused conditions that people have or think they have. You might not be sure what sciatica is and isn’t. Unfortunately, there is a lot of fear with sciatica and if you think you have it your first thought is probably something along the lines of “Oh no, my life is over”. Fortunately, it is almost never as serious as you think and many less scary conditions often are more likely the cause of your pain. Conservative treatment is also almost always effective at 100% reducing your symptoms and getting you back to what you were doing before.
What is Sciatica?
By definition, sciatica is irritation or inflammation of the sciatic nerve. Your sciatic nerve starts at your back and works its way down the back of your leg and calf all the way down to your toes. Since it is such a long nerve, sciatica is a very broad name for a lot of different conditions. Your sciatic nerve could be irritated at your back, hip, hamstring and many other places as well. This is the reason that there is so much confusion and why so many people think they have or have had sciatica.
Symptoms of Sciatica
Sciatica is almost always pain that shoots down your leg. Pain most often starts at your hip or back and shoots down the back of your leg sometimes as far as your foot. It is often a burning or shooting pain that can feel like electricity. Pain is almost always only on one leg and not both legs at the same time. Other symptoms can include:
- Numbness or tingling in the leg
- Weakness of the leg
- Back Pain
You Probably Don’t Have Sciatica If
Your pain is in a small area. If your pain is local to your back or hip then you almost definitely don’t have sciatica. There are many other types of back pain that are more likely in this case and many hip problems such as piriformis syndrome, gluteal tendinitis and others are also more likely than sciatica. Even if you have radiating pain down your leg, there are other conditions that are possibilities that don’t involve the sciatic nerve.
Treatment for Sciatica
The first step in treatment is finding the cause of the problem. This can almost always be done with movement and strength testing on your first visit. By taking you through various movements and tests, we are able to rule out or rule in where the problem is coming from. Very rarely will you need an MRI as it almost never changes what treatment will be successful. Once we figure out where the problem is coming from, treatment can include manual therapy, dry needling and exercise to improve flexibility, strength, core stability or anything else that we find on the evaluation. Conservative treatment is almost always successful but occasionally we have other experts in the medical field who we are able to refer you to if we believe you need further imaging or care.