Sciatica is a term that refers to pain of the sciatic nerve, the largest nerve in the body, which extends from the lower back through the pelvis and buttocks and down into both legs. It is a mixed nerve, meaning it allows for both movement and sensation.

This nerve plays an important role in your mobility, allowing you to walk and run! However, for different reasons, the sciatic nerve can become irritated or compressed, which causes pain known as sciatica.

Sciatica, while being a term used to describe a specific symptom, is also known by other names or descriptors, which may include the following:

• Sciatic Neuralgia: This is another term for sciatica that emphasizes an issue with the nerve itself—which results in pain that is often described as a sharp, shooting, or stabbing. This pain follows the path of the nerve.

• Lumbar Radiculopathy: The sciatic nerve has five different nerve roots, two of which are in the lumbar region. Nerve roots are the locations where a nerve branches off from the central nervous system and spinal cord. This form of sciatica refers to radiculopathy (injury, damage or compression to these specific nerve roots) and pain that occurs in the lower back. 

• Sciatic Neuropathy: Refers to damage of the sciatic nerve that results in pain, numbness, tingling, swelling and oftentimes muscle weakness.

While these terms may have slightly different meanings, they are often used interchangeably, and all in some way refer to pain of the sciatic nerve. Typically, “sciatica” is pain that is directly caused by dysfunction or damage of the sciatica nerve itself. However, the term is commonly used to describe other conditions related to sciatica or nerves connected to it.

Additionally, while sciatica generally refers to pain of the sciatic nerve, the term is often used to refer to many other related symptoms, such as the following:

• Mild pain, shooting pain, or pain that radiates to the lower back, buttocks, and down the leg—possibly continuing into the feet and toes.

• Pain that occurs after sitting or standing, or with movement such as lifting or bending the legs. Pain may also occur with coughing or sneezing.

• Tingling, or a sensation of pins and needles.

• In severe cases, numbness or weakness.

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Sciatica, generally speaking, is caused by compression or irritation of the sciatic nerve. However, there are many conditions or situations that cause compression, pressure, or irritation on the nerve. Some common causes include:

• Herniated disks: A herniated disk can cause sciatica pain if it presses onto the sciatic nerve. 

• Degenerative disk disease: This is a condition of the disks located in between the vertebrae of the spine. When these cushioning disks wear away over time from wear and tear, they can pinch a nerve as a result. In the case of osteoarthritis, the creation of bone spurs can play a part in nerve compression.

• Pregnancy: The increase in weight and shifting of the body’s structure can put pressure on the sciatic nerve.

• Injuries: Injuries can cause damage to or put pressure on the sciatic nerve, which can cause irritation.

• Spinal stenosis: A condition where the space around the spine narrows, which can put pressure on nearby nerves.

• Spondylolisthesis: Occurs when one of the vertebrae of the spine slips out of place and presses onto others around it. While minor slippage doesn’t always have symptoms, more severe cases can press onto the sciatic nerve.

• Cauda Equina Syndrome: A rare medical emergency that occurs when the nerve roots at the bottom of your spinal cord are compressed, which can be caused by a herniated disk or an injury.

Physical therapy is a very effective form of treatment and management for sciatica. In cases where the cause is not by a permanent change or damage to the body, physical therapy can help you get your body in optimal health, reduce your pain, and prevent future complications.

In other cases such as degenerative disk disease where the damage cannot be reversed, physical therapy can be a very beneficial form of management to reduce the effects of your condition, prevent future damage, and lower the risk of worsening symptoms.

One of the first treatments you may think of for sciatica is pain relief—physical therapists can provide this with a range of treatments such as thermotherapy, electrical stimulation, manual therapy, cupping, dry needling, and more. They are skilled in providing in-office treatments for pain, as well as teaching you ways to manage pain at home.

However, physical therapy doesn’t only refer to pain relief. At Hive Therapy and Wellness, our professionals take a well-rounded approach to your care, which always involves preventative health.

Physical therapists are experts in the anatomy and physical health of the body—meaning they can create the best exercise plan for your needs. This can involve strengthening of the core, back, and lower body muscles, improving your posture, and utilizing stretching or yoga to improve flexibility and balance.

Improving these aspects can help reduce the risk of pressure or compression on your sciatic nerve, reduce pain, and improve overall mobility.

Another important form of preventative health your physical therapist may incorporate into your care plan is education. They can teach you about the potential causes of your sciatica pain, and what postures or activities may worsen it.

If you perform sports or a job that may affect your risk of pain, they can teach you proper form for lifting, bending, and other daily activities to help lessen the effects on your body.

This is especially useful for jobs that involve long periods of sitting or frequent heavy lifting. They may even make suggestions to improve the ergonomics of your environment, if applicable.

With education on body mechanics, proper form, stretches to maintain mobility, and an exercise program to help you stay in shape, you’ll be in a much better condition to prevent and manage sciatica pain.

Your physical therapist will create a comprehensive treatment plan with methods that are determined by your unique condition and individual needs. The treatments commonly used for sciatica at Hive Therapy and Wellness include the following:

• Dry Needling
• Cupping
• Manual Therapy 
• Spinal Manipulation 
• Electrical Muscle Stimulation
• Tissue Scraping 
• Exercise Prescription
• Behavioral Modifications
• Therapeutic Modalities
• Neuromuscular Re-education
• Biofeedback (part of neuromuscular)
• Therapeutic Activity