Sciatica

Sciatica is a term used to describe pain radiating along the path of the sciatic nerve, which branches from the lower back through the hips and buttocks and down each leg. It commonly occurs when the sciatic nerve is pinched or irritated.

Sciatica is often a symptom of an underlying condition affecting the lower back and the sciatic nerve, which runs from the lower back down through each leg. Common conditions associated with sciatica include:

  • Obesity: Excess body weight can put additional pressure on the spine and increase the risk of developing sciatica.
  • Smoking: Smoking has been associated with increased inflammation and reduced blood flow, which can negatively impact spinal health and increase the risk of sciatica.
  • Sedentary Lifestyle: Lack of regular physical activity and poor fitness can contribute to muscle weakness and poor posture, which may increase the risk of sciatica.
  • Diabetes: People with diabetes are at a higher risk of nerve damage, including the sciatic nerve, due to elevated blood sugar levels.
  • Trauma or Injury: Previous injuries to the lower back or buttocks, such as fractures or accidents, can increase the risk of sciatica.
  • Pregnancy: Pregnant women are at risk of developing sciatica due to the pressure placed on the sciatic nerve by the growing uterus.
  • Spinal Abnormalities: Structural abnormalities in the spine, such as a misaligned vertebra or narrow spinal canal, can increase the likelihood of sciatic nerve compression.
  • Inflammatory Conditions: Conditions like rheumatoid arthritis or ankylosing spondylitis, which cause inflammation in the spine, may increase the risk of sciatica.
  • Pain: Sharp or burning pain that radiates from the lower back or hip down the buttock, thigh, and sometimes into the calf and foot along the path of the sciatic nerve.  With true-sciatica, the pain is typically worse in the leg than in the back and only affects one side.
  • Numbness or Tingling: These sensations may be felt along the nerve pathway.
  • Weakness: A feeling of weakness or difficulty moving the leg or foot.
  • Worsening with Certain Movements: Pain can be exacerbated by bending forwards, sitting for long periods, coughing, sneezing, or during sudden movements.

The intensity of the symptoms can vary from person to person, with some experiencing occasional, mild discomfort, while others suffer from severe and debilitating pain.

  • Herniated Disc: A bulging or ruptured intervertebral disc can press on the sciatic nerve.
  • Spinal Stenosis: Narrowing of the spinal canal can compress the sciatic nerve.
  • Spondylolisthesis: A condition where one vertebra slips over the one below it, potentially compressing the sciatic nerve.
  • Trauma: Injuries from falls, accidents, or impacts can harm the lower back and cause sciatica.
  • Muscle Strain: While less common, strains and tensions in the lower back muscles can sometimes contribute to sciatica symptoms.
  • Pregnancy: The added weight and pressure on the spine during pregnancy can sometimes cause sciatica.
  • Tumors or Lesions: Rarely, growths referred to as “space occupying lesions” in the spine can put pressure on the sciatic nerve.

The evidence-based approach to managing sciatica emphasises a thorough assessment to determine the underlying cause, followed by individualised treatment that often begins with conservative management. 

Surgical options are typically considered if non-invasive treatments fail to provide relief. Regular follow-ups and an emphasis on prevention through proper body mechanics are also essential components of evidence-based care for sciatica.

  • Physiotherapy: Exercise therapy to restore and improve movement, function and strength is typically highly effective.
  • Medication: Over-the-counter pain relievers or prescription medications to manage pain and inflammation.
  • Lifestyle Modifications: Avoiding prolonged sitting and incorporating regular exercise.

Sciatica is diagnosed through a clinical evaluation that includes a thorough physical examination, patient history, and possibly imaging tests like MRI or CT scans to assess the underlying cause of the nerve compression or irritation.

targeted exercises guided by a healthcare provider can be beneficial for sciatica, helping to relieve symptoms and strengthen the muscles supporting the spine..

Surgery for sciatica is generally considered a last resort and is typically recommended only when conservative treatments like medication, physical therapy, and lifestyle changes have not provided sufficient relief, or if the condition is severe and worsening. Surgical options may include:

  1. Microdiscectomy: To remove the portion of a herniated disc that is pressing on the nerve.
  2. Laminectomy: To widen the spinal canal and relieve pressure on the nerve.

Surgery may also be considered urgently in cases of progressive neurological symptoms like weakness or numbness in the legs, or loss of bowel or bladder control.

Chews health top tip for sciatica

The top tip for managing sciatica is to engage in a tailored physiotherapy program designed by a healthcare professional to strengthen supporting muscles and alleviate pressure on the sciatic nerve, combined with lifestyle modifications to prevent aggravation of symptoms.

Our Specialists

Melanie Clarke
Melanie Clarke
2023-02-22
We’ll be forever grateful to Chews, the guys are the absolute BEST IN CLASS when it comes to a fully tailored recovery plan. Our son is a young elite competitive acrobatic gymnast who sadly had a high impact fall at gymnastics dislocating and fracturing his elbow and needed surgery, for a gymnast that trains many hours over 4 days week it was devastating blow, especially with GB competitions coming up. Once out of cast (wk 4 post opp) we started 2 x weekly physio sessions with Richard Saxton (who specialises in child’s physio), he was thorough, diligent and his amazing assessments fully supported the coaches at our sons gym to help build a safe recovery plan. The sessions with Richard and Sanford were fun, engaging and they took great care to help improve full mobility and strength. At week 7 post op our son was doing skills we thought would have taken 4mths to achieve, by week 10 he was back to full impact training, even our hospital follow up with the senior elbow consultant was blown away by the physio support we’d had and the rapid recovery. If it wasn’t for Chews we 100% would not be back training this quickly and not have had the reassurances it was safe to do so…..we’ve definitely found a physio for life. Thank you from the bottom of our hearts Team Chews. From Mel & JJ x x
Ruth Shearn
Ruth Shearn
2023-02-21
Have waited a few months post-treatment to write a review - just to be certain! Quite simply, I can't recommend these guys highly enough. I went to them with two badly damaged knees (miniscus tears). Having had three arthroscopes over the years, I was completely resigned to needing surgical intervention again. The Chews team had different ideas. After showing me the latest research findings, they assured me my knees could be rehabilitated without a scalpel. I had just a handful of sessions with them and am delighted to report that, six months on, my knees are great! I'm running 5k twice a week (don't laugh, I loathe running and am no spring chicken) without any pain and have taken up tennis. Everyone at Chews is passionate about their subject, knowledgeable, reassuring and friendly. I wouldn't go anywhere else.
Dave Stuart
Dave Stuart
2023-02-06
I have had a chronic back condition to varying degrees for many years which more recently has forced me to have weeks off work at a time. I was recommended Chews Health by a colleague having tried other physios in the past. However, I always felt that something was missing from the plan. My back muscles would on occasion go into spasm, or my disk to impinge on my nerve, affecting my mobility and effectively setting me back to square one. I came to Chews health a bit wary and was considering surgery due to how much my back was affecting my quality of life and mental health. It has not been a straight forward recovery, but i have made significant progress through having a thorough history taken, my ongoing concerns listened to, and being provided with a clear explanation of not only the exercise plan but additionally explaining why my body was responding in varying ways. This has educated about my condition and provided me with the tools to self manage my condition more effectively should it deteriorate again.. It has not been plain sailing, but I have absolute faith in Jack and his team.
lobo
lobo
2023-01-09
I had to attend Chews Health for help with pain in my elbow and they have been a fantastic help. I am now back to 100%.
The S
The S
2023-01-05
I can thoroughly recommend Chews Health physio. Sessions from diagnosis to rehabilitation are stimulating as well as therapeutic. Jack’s holistic, insightful approach goes beyond fixing the initial problem - he builds the confidence and self-knowledge to help maintain fitness and avoid strains and niggling injuries in the future. His message that the body needs exposure to regular challenges has inspired my journey towards optimum health.
Sam Butler
Sam Butler
2022-12-21
Excellent physiotherapy. After ACL and meniscus surgery I contacted Chews Health to find out about how they could help me feel more confident about returning to more intense sport after my injury. I felt listened to and we worked on a series of different of exercises that tested my knee. Very helpful and I now feel much more confident in my abilities.
feralie Bennett
feralie Bennett
2022-11-23
I saw Richard Saxton for a chronic pain in my achillies. 2 visits, with massage and exercises: clear concise instruction, both written and verbal to do at home were realistic & adapted for my ability - I now no longer require pain relief & can walk the dogs pain free & even manage a few hills. A follow up call to review my progress was also appreciated. The clinic was clean & well equipped. Would highly recommend.
Philip Conroy
Philip Conroy
2022-11-16
When I had severe back pain I was seen within 24 hours. The problem was resolved after 3 weeks of physiotherapy and exercises. I subsequently took up the annual gym membership package which includes regular reviews by the Physiotherapists. I feel this has benefitted me greatly as I had no previous experience of gyms and ensured I was using the equipment in the correct manner. At all times the staff have been very friendly and professional.
Maureen Morris
Maureen Morris
2022-11-10
Helped me tremendously. Lovely people - everyone very very supportive.
Cecilia Wright
Cecilia Wright
2022-10-31
I had been suffering from plantar fasciitis for some months and went Chews Health in the summer for shockwave treatment, after my podiatrist said she had heard good reports about it. Until then I had been resting, exercising it, icing it, using insoles etc., none of which had made much difference. I booked six treatments at the start (recommended) and by the time of the last treatment It was hardly noticeable, so much better! I’ve had two further treatments over the last month, just to be on the safe side, and I’m doing some exercises now to build up the strength in my calf and foot. Chews Health comes with heartfelt recommendations from me, they are friendly, very knowledgeable and best of all - they have fixed my sore foot!