Low Back Pain and Sciatica
Lower back and sciatic pain are interconnected medical conditions and many times, sciatica is the result of a mechanical back problem. The sciatic nerve is the longest nerve in the human body and consists of nerve roots in the lower back that runs through the buttock and down the back of each leg. Portions of sciatic nerve branch out to the thigh, calf, foot, and toes. Sciatic nerve pain is often characterized by the following symptoms:
Lower back pain that radiates down the leg
Leg pain with burning, tingling, or sharp pain
Continual pain on one side of the buttock
Numbness in the leg or feet
Pain with prolonged sitting and difficulty getting up
Sciatica is actually a symptom of an underlying lumbo-pelvic problem. Effective treatment requires the root cause to be identified. Common lower back problems that can cause sciatica include degenerative disc disease, lumbar spinal stenosis, sacroiliac joint dysfunction, lumbar herniated disc, and spondylolisthesis.
Degenerative Disc Disease
Disc degeneration is a natural process that often occurs as we age. For some people it can occur younger than expected. One or more degenerated discs in the spine or lower back can irritate a nerve root and cause sciatic pain. This disease is diagnosed when a weakened disc is exposed. Bone spurs may also develop in the spine with disc degeneration and cause sciatica.
Lumbar Spinal STENOSIS
Lumbar spinal stenosis is caused by a gradual narrowing of the spinal canal in the vertebrae. It’s also common in the aging process and typically affects those over 50. It can be a result of a bulging disc, enlarged facet joints, bone spurs, arthritis or an overgrowth of soft tissue. Whatever the cause, it can result in back and sciatic pain.
Lumbar Herniated Disc
This condition occurs when the soft gel material of the disc leaks out and passes through the outer wall irritating the sciatic nerve. Sciatica is the most common symptom of a herniated disc. It’s also known as bulging disc, slipped disc, ruptured disc or protruding disc.
Spondylolisthesis occurs when a small stress fracture causes one vertebra to slip forward on another. Spinal instability and disc space collapse may occur along with the forward slippage. This typically occurs at the L5-S1 spinal levels and results in pinching of the nerve leading to sciatic pain.
Sacroiliac Joint Dysfunction (SIJD)
SIJD is a common condition and prevalent in people experiencing lower back issues. SIJD from altered pelvic mechanics occurs either from an increase or decrease of expected normal motion or the presence of an unusual SIJ motion. It includes pain arising from the joint itself or the structures that surround the SIJs such as the sacrotuberous, sacrospinous, and/or iliolumbar ligaments.
The prevalence of sacroiliac joint pain has been reported between 13-30% of the population. Specifically 13% of individuals with low back pain have pain arising from the SIJ. Thirty percent of all patients seen in outpatient PT clinics have pain arising from the SIJs. Twenty five percent of pregnant women have SIJ pain, and 7% of post-partum women have significant and debilitating SIJ pain.
How Physical Therapy Can Diagnose & Manage Lower Back Pain and Sciatica
Extensive research has proven that physical therapy is effective for those who suffer from lower back pain, SIJ pain or sciatic pain. It’s safe, cost-effective, drug-free, non-invasive, and in some cases physical therapy treatment can even reduce the need for pain medications and expensive imaging studies like MRIs and X-rays.
When our physical therapists work with you to address your lower back and sciatic pain, the main goal will be to reduce your symptoms and alleviate the pressure on the sciatic nerve so that your symptom relief is longer lasting. Additional goals will be to heal the injured tissues, reduce inflammation, improve core stability and strength, restore function, and ultimately get you on a sustainable exercise program to help you maintain your activities for the future.
In order to achieve these objectives, your sciatica or lower back pain plan of care may include:
Manual therapy including: soft tissue mobilization, joint mobilization, functional movements therapy and spinal traction
Non-invasive modalities including: electrical stimulation and therapeutic ultrasound
Heat and ice treatments are utilized to assist in pain relief and preparation of tissues for manual therapy.
Therapeutic exercises, stretches, and core stabilization protocols that are essential to restore your core strength and support your spine.
Are you experiencing lower back pain or symptoms related to sciatica? In Idaho, patients are allowed direct access to physical therapists, meaning they don’t need a referral from their primary care physician for most insurances.
We encourage you to talk to us or your doctor about getting started with a physical therapy program. Contact us today at Pinnacle Physical Therapy to learn more and get back to an active and pain-free lifestyle.