Often, when a person complains of hip and back pain, the most common diagnosis is sciatica. The quick answer is Sciatica or the inflammation of the sciatic nerve is actually a very specific source of pain. The sciatic nerve's origin and path starts just at the top of the gluteal muscle in the L4 and L5 vertebrae. When inflammation occurs in this area, it can compress the sciatic nerve and send a radiating pain down the back of the leg, typically ending at the back of the knee but also radiating down to the calf.
Sciatica is always caused by inflammation around the sciatic nerve. The source of this inflammation maybe low back pain which can include a bulge in the L4 or L5 vertebra, commonly called a pinched nerve in the lower back. Inflammation of portions of the hips and glutes can also cause sciatic pain, but because the sciatic nerve is deep, the inflammation is typically also in a deep rather than superficial part of the anatomy.
Image of Sciatic Nerve Pain
Lower back and hip pain may increase with forward bending or flexion of the hip joint. You may know you have sciatica because the pain radiates down the leg when you bend over. For this reason, sciatica often treated with gentle back bends and mild external rotation of the hip. If you suffer from bad sciatic pain, you may even consider sleeping with the affected leg in the butterfly position.
If sciatica is caused by a bulging disc in the lumbar spine, it will be critical to work with a doctor to know when motion can be reintroduced to this area of the body. Forward bending is contraindicated for any lumbar bulge. Training to properly engage the muscles of the core will be very important in healing this injury. Strengthening, lower back stretches, exercises for the hips, stretching the hamstrings may help restore the spine's natural curvature and function to help reduce sciatica pain. Exercises for hip pain and stretches for sciatic nerve pain must be performed gently at first to avoid irritating lower back structures. To learn more about sciatic nerve stretches, go to this ARTICLE. Here is one example of a stretch which can help!
Piriformis Stretch for Sciatic Nerve Pain
Massage therapy can help relax the muscles in the back it can and loosen some of the muscles that are affected by the sciatic nerve. It helps circulation in the back, and if you suffer from chronic sciatic discomfort, massage therapy is a good way to help prevention of sciatic nerve pain.
Physical therapy can include a variety of modalities that include massage, electrotherapies, heat or ice and exercises. Physical therapy is intended to help reduce pain, inflammation and muscle spasms. Physical therapy also consists of education and training to learn about correct movements and postures that can best help you and your sciatic nerve pain.
Location of the Sciatic Nerve
Support and posture is very important for treating sciatic nerve pain. Sitting on hard or uneven surfaces can aggravate the sciatic nerve therefore, making sure there is good support and posture for your low back can help. If you sit at a desk for long periods, make sure you have a chair that tilts and shifts your weight can reduce stress on the lower back creating less pressure and pain. Sleeping with side bent knees can also help align posture while you are sleeping.
Some patients have reported relief by using the Voltaren cream and other analgesic creams.
To schedule a physical therapy appointment at one of the 12 JOI Rehab Centers, please call 904-858-7045.
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By: Ehren Allen, PT, Certified Manual Therapist
