Can physiotherapy help sciatica, explained by Shane Brennan – chartered physiotherapist at Mid West Physiotherapy, Limerick.
What is sciatica?
Sciatica is defined as an irritation of the sciatic nerve – a strong, thick nerve that passes from the lower spine, through the buttocks, and down the back of the leg. There are any number of reasons why that nerve can get irritated – from disc/bony changes in the lower back, to muscular tightness around the hip. The key to good treatment of sciatica is finding out what is causing the nerve to be irritated.
What does it feel like?
Sciatica is described as a shooting/stinging/burning pain down the back of the leg, which can travel all the way from the buttocks to the heel, or part of that distance as far as the knee. Sometimes there can be pins and needles or numbness associated with it.
How long will I be injured for?
Sciatica, if left untreated, can persist, and can sometimes develop into worse symptoms. It is important to get an assessment as soon as possible. In a small number of cases, sciatica is a symptom of a different problem in the lower back which may need surgery. Thankfully, physiotherapy has been shown to be effective in the treatment of sciatica, and the natural course of recovery is favourable [Verweord]. We generally find that people make the most improvement in the first couple of weeks after starting physiotherapy.
Will I need surgery?
In a small number of cases, surgery is sometimes required. However, conservative treatment such as physiotherapy should always be used as a first preference [Singh 2021]
What does a typical recovery trajectory look like?
Depending on the cause for your specific pain, people can generally start to improve quite quickly once they start physiotherapy. For example, if your pain is caused by muscular weakness & tightness (which it often is), people will usually leave their first appointment feeling much freer than they did when they arrived! After that, it’s about finding out what day to day movements are aggravating things and making some adjustments to sort that out. In general, people tend to be back to themselves within 4 to 6 weeks after starting physiotherapy.
What type of rehab exercises will I get?
The scientific evidence shows us that no single-method therapy is recommended for treating sciatica [Kuligowski 2021]. That means that we can try a variety of different exercises to get you back to what you love doing best. I usually go for a combination of hip stretching, glute strengthening, and neural glides, but there are loads of different exercises to choose from! The key thing to figure out is what exercises make you feel good, and what exercises are you likely to keep doing going forward.
How often do I need to do my rehab exercises?
Initially, it will be important to do your exercises every single day, and maybe even a few times per day. As you get better, and the exercises get a bit more challenging, you may not have to do them as regularly, as we wait for the muscles to recover between exercise sessions
How long should I spend doing my exercises?
I always tell people that they should be able to get all their exercises done in under 30 minutes per day. That might be 3 separate 10 minute sessions, or it may mean doing 1 30 minute session daily. Usually, we are able to figure out what works for each person and come up with an individual plan
When can I return to my favourite activity?
This all depends on how you are responding to the treatment, but we usually find that people can get back to their favourite sport and activity within a month or 6 weeks of starting physiotherapy.
Where can I find more information about sciatica?
the HSE has a good section on sciatica on their website; click here to read.
Can I book an appointment with you?
Yes! If you would like us to assess your sciatica and give you a tailored recovery plan, you can book an appointment with us online, or your can contact our Reception by ringing 061-201444 or emailing info@midwestphysio.ie.
