Sciatica is a common health complaint in the UK which affects up to 43 per cent of the population. Sciatica can present with or without lower back pain, but it carries other associated symptoms.
The most common symptoms of sciatica are numbness and pins and needles in the lower limb that presents along the sciatic nerve. Patients can experience numbness and tingling anywhere from the origin of the sciatic nerve in the spine and throughout the length of the leg.
While some people may feel pain or pins and needles in their lower back and buttocks, others will feel the same symptoms in their lower leg and foot. This is why it can be confusing for anyone experiencing these symptoms for the first time. They may know someone with sciatica but with pain, numbness and tingling in a different area, so they won’t automatically think it is the same condition.
How sciatica is diagnosed
If you experience these symptoms, you should visit your GP. Your doctor may refer you to a physiotherapist for a proper diagnosis, targeted treatment, and support.
Your physiotherapist will look for the most likely cause of your sciatica. This condition can be triggered by damage in or around the lumbar spine (lower back), such as a bone fracture from an injury, a herniated disc, or degenerative changes such as spondylosis and spondylolisthesis.
Other issues that can lead to sciatica include:
- Changes during pregnancy
- Hip dysfunction or after hip surgery
- Piriformis muscle pain
- Sacroiliac joint dysfunction
Your physiotherapist will conduct a thorough examination and perform a number of diagnostic tests, such as an MRI, to help rule out other causes for your symptoms and narrow down the reason.
How sciatica is treated
Treatment for sciatica will be personally tailored to your needs. It will include manual techniques administered by your physiotherapist alongside a gentle regime of exercises and stretches that are aimed at strengthening your supporting muscles and building and maintaining joint flexibility.
Your treatment programme will be created based on your current symptoms and pain threshold. Your plan will be monitored and reviewed regularly to ensure it remains effective and continues to improve your core stability, strengthen your supporting muscles and joints and help prevent further recurrences of your symptoms.
Your physiotherapist will help to treat the cause of your sciatica and enable your sciatic nerve to move and stretch freely within all the structures it passes through. Your treatment may include soft tissue and joint mobilisation but may also include acupressure or acupuncture to aid your progress.
There is no one-size-fits-all approach to treating sciatica, so your physiotherapist will assess your symptoms and determine which structures along your sciatic nerve cause your issues.
How long for sciatica to heal?
It is important to seek diagnosis and treatment for our sciatica as quickly as possible. Without proper medical intervention, your symptoms will worsen and become more debilitating.
In most cases, sciatica symptoms will resolve themselves with plenty of rest and gentle exercise over four to eight weeks for a temporary flare-up. It can feel like an eternity for some people depending on the level of pain and discomfort you are experiencing.
This is why it can help to consult with a physiotherapist to help get you through the flare and build up your muscle strength and flexibility to help reduce the risk of future flares.
However, for some people, sciatica doesn’t heal over time, and they will need to stay on top of a long-term treatment and maintenance plan that their physiotherapist can devise and implement.
Does sciatica ever go away?
Reoccurring sciatica can be a problem for some people. In most cases, sciatica will resolve eventually, and with proper care and attention, you can minimise your chances of having repeat flares.
However, a minority of people will need to have ongoing treatment for sciatica, especially if the cause of their pain and symptoms is due to permanent sciatic nerve damage.
Sciatica exercises NHS
The NHS recommend consulting with a physiotherapist to get personalised treatment for your sciatica. However, their general advice to help relieve sciatica-related pain and to speed up recovery is to continue with gentle exercise and carry on with your normal daily activities as much as possible.
The NHS recommends starting and maintaining regular gentle exercise as soon as you can; anything that keeps you moving can help relieve symptoms. Walking, swimming and mild stretching are all good exercises to take.
Your GP may suggest exercises and stretches you can do at home, or they will refer you to a physiotherapist for more personalised help with a tailored exercise programme based on your symptoms. Referral to an NHS physiotherapist is very common, but waiting times can be long.
You can get a faster diagnosis and access to effective treatment much quicker by going private. You can book a private consultation with Dr Bhadauria and his support team in one of his London-based clinics.
Dr Bhadauria is a consultant rheumatologist and pain specialist that offers a holistic approach with accurate diagnostic and treatment that includes physiotherapy, diet and lifestyle guidance and support.
Are sciatica and shingles related?
While several health issues are associated with shingles, it is still unclear whether sciatica is a stressor that triggers a shingles flare. There have been studies looking at the occurrence of shingles in patients with sciatica across a section of age ranges and genders, but no strong links have yet been proven.
One study conducted between 2000 and 2012 involving 49,023 patients with sciatica and 49,023 matched controls without sciatica concluded that female patients were more likely to develop shingles than male patients. The results show that there is a slightly increased risk of sciatica patients developing shingles, especially in those over age 50.
How much does sciatica hurt?
Most people experience sharp stabbing pains that radiate from the lower back and down into the leg. People can constantly feel pain and discomfort in their lower back until the symptoms subside.
Some painful conditions are similar to sciatica, so if you have ever experienced these, the pain is not dissimilar:
- Herniated disk
- Pinched nerve
This is why it is so important to see your GP or book directly with a trained physiotherapist to help get some effective pain relief and treatment for your condition.
Sciatica is a painful condition. The pain experienced can make it challenging to perform many everyday tasks. It may be the case that you get flares of sciatica with long respite periods in between, or you suffer less severe but consistent sciatic pain.
Where is the sciatic nerve?
The sciatic nerve is the largest nerve in the body. Its roots start in the lower or lumbar spine, which joins together to form a thick nerve bundle not dissimilar to a rope. This rope-like nerve travels from the lumbar spine through the buttock and down the back of the leg to anchor at the knee.
From the knee, the sciatic nerve splits into smaller nerve branches that travel down and radiate to areas of the lower leg and foot. The sciatic nerve pathway is like a communication line where messages need to travel freely in both directions.
The sciatic nerve is a flexible structure that needs to stretch and slide within its sheath as we move. Should the nerve be trapped or pinched, inflamed or becomes stuck at any point along its corridor, the flow of chemical and electrical messages gets interrupted, and, this is when you start to experience symptoms such as sharp stabbing pains, tingling, hot or cold feelings, numbness and pins and needles.
You should talk to your GP if you notice that your symptoms are reoccurring more often or lasting longer than a few weeks. If you are getting no relief from home treatments or your symptoms are interfering with your daily tasks, it would be wise to have your symptoms checked by your doctor to rule out any other underlying health condition that shares similar symptoms to sciatica.
Suppose you are experiencing persistent symptoms of sciatica, and they don’t seem to be going away with time and gentle exercise, and you don’t want to wait for weeks to see an NHS physiotherapist. In that case, you can seek practical help by booking a private consultation with Dr Bhadauria and his team, where you can access effective treatments, including pain relief and professional physiotherapy.
Article by Dr. Naveen Bhadauria