Sciatica: Overview of Low Back Pain

By Jared Ernest, Physical Therapist

An Overview of Sciatica

The nerves that leave the lower lumbar spine join together to form the large sciatic nerve. This nerve provides sensation and controls the muscles of the lower leg. Sciatica refers to the pain felt when the sciatic nerve is irritated or pinched. Therefore, this pressure or irritation on the nerve roots can interfere with the normal function of the sciatic nerve, which results in pain down the leg.

Illustration of the torso and lower extremities showing low back pain from sciatica. JOI Rehab

An Overview of Sciatia

Causes of Sciatica

Radiating pain, numbness, and/or tingling down the back of the leg can be indicators of sciatica. This can be caused by many different orthopedic conditions. A variety of differential tests, such as the passive straight leg raise and seated slump test, can be used to diagnose sciatic nerve pain. Your physician may order an MRI as another diagnostic tool to diagnose sciatica.

Symptoms of Sciatica

Although pain or discomfort can occur at any point down the nerve pathway. Sciatica pain typically flows from the lower back and buttock to the back of the thigh and calf. Pain ranges from mild discomfort to a sharp, excruciating pain that can be triggered by everyday activities.  Sitting in one place for a long time is usually only present on one side of the body. While mild sciatica may fade over time, you should call your doctor if pain lasts longer than a week or gets progressively worse. Seek immediate medical attention if this pain immediately follows a violent injury or if you experience sudden, intense pain and/or numbness or weakness in your lower back or leg.

Risk Factors Related to Sciatica

There are several risk factors related to Sciatica.

  • Age: Sciatica is more common between the ages of 30 and 50, and age-related changes in the spine such as bone spurs and herniated discs can cause sciatica.
  • Obesity: Higher body weight puts excess stress on the spine, contributing to spinal changes.
  • Occupation: Jobs that require you to carry heavy loads, twist the spine, or drive a motor vehicle for long periods of time contribute to spinal problems.
  • Diabetes: Those with diabetes are more prone to get sciatica because of the increased risk of nerve damage.
  • Sedentary lifestyles: Those who sit for long periods of time put excess stress on the lower back and legs, making them more prone to get sciatica.
Spinal Disc Herniation

Disc Herniation

Sciatica Complications

While the majority of people fully recover from sciatica, it can cause permanent nerve damage if not treated correctly. Some possible complications include:

  • Loss of feeling in affected leg
  • Inability to move the leg
  • Weakness in leg
  • Loss of bowel or bladder control

If any of these symptoms are present, contact a healthcare professional immediately.

Lifestyle Changes and Home Remedies for Sciatica

Sciatica pain can be helped and avoided by having good posture and ergonomics. Therefore, you should set up your office ergonomically if you want to avoid sciatic and lower back pain.  Other home remedies are the use of a heating pad or home made rice bag for moist heat. Another home remedy frequently used is a sciatic nerve belt or harness.

Lastly and perhaps most importantly is to live a healthy lifestyle.  Eat a healthy diet and exercise regularly. If you are interested in scheduling an appointment at JOI Rehab for physical therapy, call (904) 858-7045.

To learn more about the anatomy of the spine, please watch this video.

To learn more about sciatica, please go to how long does sciatic last

Treatment of Sciatica

If pain doesn’t decrease with self-help measures such as rest and stretching, the following treatment options are available for patients:

  • Medications: Please consult your physician for appropriate medications.
  • Steroid Injections: Also known as corticosteroids, these can be injected around the affected nerve root in order to suppress inflammation and reduce pain.
  • Physical Therapy: Our physical therapists at JOI can assist you with managing your pain and can design an exercise program to help you avoid future injuries. These programs typically include exercises to strengthen the back, improve your posture and increase flexibility.
  • Surgery: This is a last resort if pain is still present or worse after medication and therapy.

To learn more about how to stretch the sciatic nerve correctly, please read this 3 sciatic nerve stretches.

Sciatic Nerve Stretch

Piriformis Muscle Stretch for Sciatic Nerve Pain

JOI Rehab’s Conservative Physical Therapy Options for Sciatica

Sciatica is a common injury in the lower back that causes pain. Just like there are many reasons for low back pain there are also many ways to treat it in Physical Therapy. Joint mobilization, which is a hands-on technique to improve mobility of the joint, is also used to treat low back pain and sciatica. Medical massage, which is performed by licensed massage therapists, has become much more popular in treating low back pain injuries such as sciatica. Dry Needling, an alternative physical therapy treatment, is also useful in healing sciatica symptoms. Laser therapy is another option in treating sciatica.

Ergonomic education is important in treating low back pain, as the source of most of the pain comes from how people sit and/or stand for extended periods at a time.  To learn more about a catch in your back, please read this catch in upper back.  Lastly and perhaps most importantly is to live a healthy lifestyle. Eat a healthy diet and exercise as much as possible.

By: Jared Ernest, PT

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