Sciatica is a general term used to describe any pain referring down the leg that emanates from the lower back. It is non-specific and used more commonly by the general public than health professionals. The sciatic nerve is the largest nerve that exits the spinal cord at the lower back and travels down the back of the leg. The lumbar spine, spinal cord and sciatic nerve can all cause pain into the leg, which can make specific diagnosis difficult.
The most common causes of sciatica are:
- Lumbar spine disc bulges
- Facet joints (the joints between vertebrae)
- Sciatic nerve impingement
- Soft tissue sprains and strains
Each condition has a different management but general tips for all problems are:
- Try to keep active. Prolonged bedrest should be avoided. Try to continue on with your activities of daily life as much as you are able.
- Pain moving further down the leg is an indicator the problem is worsening. Centralizing pain is a sign of improvement – even if the back pain has worsened if the leg pain has stopped, it is healing.
- Avoid activities that cause the leg pain to worsen, particularly if it worse after he activity has stopped.
While it’s always best to see a health professional to design the optimum treatment plan for you, below are some simple exercises that are often helpful.
Remember to stop the exercises if they are increasing the pain down the leg.
Lumbar spine Disc Bulge
The McKenzie Extension is named after Kiwi physiotherapist Robin McKenzie. It is helpful for many over back disc problems. 2-3 sets of 10 is a good start. Ensure to stop if pain down the leg increases.
Facet Joint Strains
Lumbar rotations
Rotate the legs to one side while looking to the other. This counter force will allow the joints to open up. Don’t be surprised if your back ‘cracks’ while doing this. Do 1-2 sets of 10-15 both sides. You can experiment with different levels of hip angle: knees closer to the chest works higher up the lumbar spine, while feet closer to the floor works engages the lower levels.
Sciatic nerve impingement
Slump stretches are best done sitting on a bench with feet hanging in the air. Begin with ankle straight and head up. Then to increase tension bend ankle to the body and dip head down. 2 sets of 10 reps .Always do with care and monitor symptoms before, during and after.
Soft Tissue Strains
Lumbar flexions. Brining the knees to the chest and pulling. You can extend by pulling hips all the way up and roll in a ball to open the spine and stretch the soft tissue.