What Is Sciatica?
Sciatica is defined as pain and/or numbness and tingling that travels into your glutes and down the back of your leg.
Sciatica has become a blanket term for all radiculopathies, but in general, if the pain travels down the back of the leg past your knee, there’s a chance the sciatic nerve is involved.
This is usually caused by nerve compression in your lower back, but the sciatic nerve can also be entrapped along its nerve pathway resulting in sciatica symptoms.
- Pain is usually described as a sharp, burning, electric feeling, and may include paresthesia (numbness and tingling). This pain travels from your back and radiates into your butt and into the lower leg.
- Pain is made worse with flexion activities such as bending forward and sitting.
- Less common symptoms include muscle weakness and reduced reflexes.
- If bowel and bladder issues are present, this is a medical emergency and medical attention should be sought immediately.
These are a few diagnoses that can present similarly to sciatica. Most of these will be treated roughly the same way, except for the red flag items. In those cases, your physical therapist will refer you to the appropriate medical provider for further testing and treatment.
- Other Lumbar Radiculopathies
- Piriformis Syndrome
- Red Flag Items such as Tumors and Abscesses
What Does This Mean For You?
Sciatica symptoms suck. Having an understanding of what sciatica is can be helpful in your recovery.
But at the same time, DO NOT GET OVERLY CAUGHT UP WITH WHAT THE DIAGNOSIS IS OR CAN BE.
This is a rabbit hole that many people end up falling into when it comes to their injuries.
Your diagnosis is NOT the only factor that determines recovery. Your current symptoms actually weigh more when considering your plan of care than the diagnosis itself.
The goal of physical therapy is to identify which movements are painful, which can be performed without making your symptoms worse, and which movements make you feel better.
Once these three things are established your rehab plan can be developed. This is why it is important to get assessed. The information found in your assessment can shed light on why the injury occurred, and what the plan for recovery should be.
Should You Get An MRI?
My typical advice for those dealing with lumbar radiculopathies is; you do not need to get an MRI. You can if you want, but I recommend going to see a local physical therapist or setting up a discovery call with me to learn more about working with me virtually.
Start with getting treated. Almost every state has a Direct Access law, meaning, you can see a PT without needing a doctor’s script. Going directly to your local PT will help save you time and money as there will be fewer co-payments for you to pay.
If your symptoms do not begin to resolve after a few weeks of rehab, then I recommend going to get an MRI to rule out more sinister causes.
The reason you don’t need an MRI initially is because your MRI does not dictate your treatment. It is good information to have but is not needed to create a plan of care.
Sometimes there are things that pop up in your evaluation that tells the PT that you may need an MRI. They will be able to tell you if you need one and refer you to the appropriate medical provider.
Here is another reason you don’t NEED to get an MRI. Most cases of sciatica resolve in less than 4-6 weeks with no long-term complications even if no medical therapy is sought (1).
Why would I cite a research article that says you don’t need physical therapy to recover from this injury?
For 2 reasons:
- To help you realize that this type of injury is not a death sentence and that recovery is possible.
- There is still a reason the injury occurred in the first place. Let a skilled practitioner guide you through the recovery process and help you get to the root cause of the injury.
As mentioned earlier, treatment begins with finding what makes your symptoms worse and what improves them.
From there, reducing pain is the first step.
As your pain levels decrease, the goal is to start working on improving your function.
- Reduce nerve tension
- Improve mobility limitations
- Improve strength and stability
- Improve capacity for higher-level tasks (sport, running, work, etc…)
Below are some common exercises that are used to treat sciatica. Please keep in mind that these exercises are for educational purposes and are not intended to treat your injury.
If you do perform these exercises, they should make you feel better, not worse. If pain levels increase, it means the exercise(s) are too advanced and you may need a different variation. You can always email me or set up your Free Discovery Call to chat further.
Discovery calls are free 15-minute calls to talk through your injury and figure out if you are a good fit for a virtual consult.
Cat/Camel Series – perform 3 sets x 5 reps per segment
Sciatic Nerve Glide – perform 3 sets x 10 reps per side
Active Straight Leg Raise – perform 3 sets x 8 reps per side
Hip CARs – 2 sets x 3 reps forward and backward, daily
If you have any questions, please let me know! Drop a comment below or email me at email@example.com