Sciatica in Happy Valley
What Is Sciatica?
Sciatica is a condition that describes symptoms of leg pain, tingling/numbness, and/or weakness that radiates down from the low back through the back of your leg, possibly all the way into your foot. The underlying cause of your sciatica can vary from a few sources.
Conditions That Cause Sciatica
- Herniation or bulge of a lumbar disc. See below.
- Moderate to severe spinal stenosis. See below.
- Piriformis syndrome. See below.
Common Symptoms of Sciatica
Do any or all apply to you?
- Pain that originates in the low back or buttock and then radiates down the back of your thigh, possibly all the way into your foot.
- Pain worsens with sitting.
- Pain that you would describe as burning, sharp shooting pain, numbness, tingling, or electric.
- Feelings of weakness or heaviness in your leg or foot.
Individual symptoms can vary between occasional and annoying to unrelenting and devastating. These differences are explained by the underlying cause of your sciatica and it’s particular severity.
Most people who experience sciatica can expect a full recovery within 4-12 weeks with physical therapy treatment; sometimes even faster! Receiving a thorough examination to determine your underlying cause is critical for successful treatment.
If these situations emerge, a consultation with your primary care is warranted immediately:
- Symptoms are unrelenting and continue to worsen without any relieving factors.
- Symptoms are present in BOTH legs.
- You lose voluntary control of bowel or bladder function. This could indicate cauda equina syndrome and could lead to permanent damage if not corrected with surgery quickly.
The Sciatic Nerve
The sciatic nerve is acknowledged to be the largest nerve in the body. It begins at the base of your lumbar spine and travels down through your glutes and down the back of your legs to your toes. The nerve has a few splits to localized areas along the way. Symptoms typically develop from a source of irritation somewhere along the path of the nerve. Common irritants involve prolonged compression or a sudden traction, or stretching, event. The location of the irritant will dictate where your symptoms will be felt. The duration and severity of the irritant will dictate the intensity of your symptoms.
Examples of possible symptoms experienced are identified above.
The 3 most common causes of sciatica include:
Herniation/Bulge of Lumbar Disc
The cause of a herniation or bulge varies but the result is usually the same. Localized inflammation develops and creates swelling while releasing pain receptor chemicals. The nearby nerve root then becomes compressed or irritated by the inflammation or from direct contact with the bulging material.
Spinal Stenosis in Lumbar Spine
Spinal stenosis is defined as a narrowing or reduction in space. This can lead to increased compressive forces on the local nerve root leading to symptoms. The stenosis can originate from reduced disk height or arthritic changes in the foramina.
This condition describes an irritated or tense piriformis muscle which can compress the sciatica nerve in the gluteal region. Most people’s sciatic nerve runs under the piriformis muscle but some individual’s sciatic nerve actually splits through their piriformis muscle. There’s no way to identify your structure without a surgery or diagnostic imaging. Luckily, in the majority of cases, you don’t need advanced imaging or a surgery to resolve the problem.
Physical Therapy Treatment For Sciatica
The goal of physical therapy for sciatica is to identify the underlying cause of your nerve irritation. A prescriptive stretching, mobility, and strengthening program is developed based on the source of your pain, as determined through a physical examination.
Initial treatment strategies revolve around decreasing compression or irritation to the sciatic nerve quickly for resolution of your inflammation. Once symptoms are under management, a strengthening, stability, and mobility program is transitioned to for full recovery and prevention of recurrence.
Active treatment strategies are critical for long term relief of sciatic pain – pain avoidance beliefs will cause people to reduce their activity levels to zero trying to reduce symptoms. However, nearly all research indicates that avoiding all activities leads to minimal, at best, initial recovery but worse long term outcomes. Movement is critical to many body functions, so avoiding activity will begin to cause disruptions to other body systems – including you muscles and joints.
Once again, the most key factor to begin recovering from your sciatica is to properly identify the underlying source of irritation. A thorough examination with one of our doctors of physical therapy will get you started down the right path. Engaging in certain activities can worsen sciatica depending on the source of your symptoms. If sciatica is a problem you’ve been experiencing and has been interfering with your life, call us today to get started on a plan of care that works for you. Ascent Physical Therapy is conveniently located off Sunnyside Road in Happy Valley. We also love treating our neighboring communities of Damascus, Gresham, Clackamas, and Sandy at our top rated physical therapy clinic!