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By Dan Bosy, RPT

Lower back pain is one of the most common pain complaints that people experience.  It can be accompanied by pain radiating or shooting down the back of the leg to the foot.  A physician may diagnose this as “sciatica,” but is it really sciatica?

What is Sciatica?

The Merck Manual defines sciatica as a pain along the sciatic nerve.  The sciatic nerve is the largest nerve in the body.  In runs from the lower back into the buttock, down the back of the thigh then branches into almost all aspects of the leg and foot.  When there is pressure on it, you are likely to experience sharp pain with standing or walking, weakness, numbness or difficulty moving your leg, foot or toes.  The pain is often burning or searing and may be mixed with tingling.  It is often worse with sitting. 

What are the causes?

Sciatica can be caused by pressure on the sciatic nerve.  The most frequent causes include disc herniation, nerve root impingement, spinal stenosis, spondylolisthesis, tumours, piriformis syndrome and sacro-iliac joint dysfunction. 

What can you do at home?

There is no single approach that will be helpful for everyone.  The treatment often depends on the cause, although there is one commonality present in every approach.  The pressure needs to be reduced on the pain sensitive structure – in this case the nerve.  When this happens it should feel like the pain is moving towards the back.  This is called centralization.  However, if there is more pain or increased pins and needles or tingling that is replacing the pain, this is not better.  If repeated movements centralize the symptoms, then there is a directional preference that will help to make the symptoms better. 

I have heard some people say that they thought the pain will continue to move beyond the foot when it spreads there.  This will not happen.  As the symptoms spread further down the leg and into the foot, there is even more pressure somewhere along the sciatic nerve.  Whatever activities or movements that increases the spread your symptoms, they will need to be avoided.

What can Awakening Health do to help you?

Awakening Health has four different practitioners that can help you recover.

Our physiotherapist will perform a thorough assessment starting with a detailed history of the injury, past history and injuries, how the symptoms currently behave as well as the level of pain. Then a physical assessment will look at the posture and alignment of the back, hips, legs, and feet.  Movement testing, both actively and passively, will look at the biomechanics and joint mobility. Nerve function will be assessed as needed.  Strength testing will help find the most significant muscle imbalances and then palpation will help determine the areas of pain and tightness that are contributing to the symptoms. Treatment will be discussed and exercises prescribed as appropriate to address the findings and help to reduce the symptoms and return to regular activities.

Our massage therapist will help to reduce the tension and tightness through your back and lower extremities to reduce the pressure on the sciatic nerve.

Our osteopathic practitioner will look at additional factors that can slow the recovery like abdominal tightness, fascial tightness and neurological issues.

Our naturopath will listen carefully to your health story and ask lots of questions to look for any nutritional or lifestyle factors that may be contributing to your sciatic pain. Treatments will be aimed at optimizing nutrition, minimizing pain and addressing any barriers/blocks to healing in order to make provided exercises and other previously discussed treatments most effective and prevent the sciatic pain from coming back in the future.

This article contains health information.  It is for informational purposes only and is not intended to provide health care advice.  For advice specific to your concern, please consult a regulated healthcare provider.


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