Is physiotherapy helpful for sciatica?

Doctor's Answer

Sciatica is classically described as shooting pain that travels from the buttock down to the leg and can be associated with altered sensation or strength in the leg depending on the underlying cause. The reason this develops is because the sciatic nerve, is irritated somewhere along its pathway and hence you experience either pain or sensory changes. The commonest reason for sciatica is due to irritation from the spine, either from a bulging or prolapsed disc, or from nerve root irritation from facet joint swelling. This then causes the pain.

Other causes I have seen in clinic are from irritation of the sciatic nerve at the level of the piriformis, otherwise known as piriformis syndrome, and following a hamstring injury in a footballer. In this case, it was due to the swelling around the nerve from the torn muscle and hence the sciatica symptoms.

Physiotherapy is a useful method of improving your symptoms; it can improve strength and postural control around the trunk while also relieving tightness in other muscle groups. If there is a functional element to your back pain, it can help to resolve this. In more acute cases, physiotherapist can apply traction to your back to take the pressure off the nerve from disc bulges etc. If you already have a diagnosis of why you are experiencing sciatica, and provided it is nothing that requires further intervention, I would certainly start with physiotherapy. However, if you do not, it may be worthwhile looking into it further before treating.

I hope this helps.

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