Sciatic Pain: Causes, Diagnosis, and Treatment Options

Many people have suffered from something called sciatica or at the very least know someone who has. Sciatica is a condition that results from compression of the sciatic nerve. Symptoms can be felt in various locations from the lower back, buttocks, or into the leg and can range from pain to numbness and tingling. Sciatica can be caused by several different conditions. Spinal stenosis, DDD (degenerative disc disease), and herniated discs are some of the more common causes.

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Common Cause of Sciatica

Spinal stenosis: Spinal stenosis is a very common condition that happens to most people with age. It is a degenerative change of the spinal canal that results in compression of the nerves, which causes symptoms.

DDD: Between each vertebra in our spine is a disc filled with fluid. As we age, the discs tend to lose fluid and therefore lose height. This is referred to as DDD or degenerative disc disease. When there isn’t as much space between each vertebra it can result in nerve compression.

Herniated Discs: When people talk about herniated, bulging, or protruding discs, they are referring to something that occurs when the central part of a disc, called a nucleus, bulges into the fibrous rings that surround it. It then presses into the spaces between the vertebrae and compresses the nerves.

Diagnosing Sciatica

Getting a proper diagnosis is crucial to finding the treatment approach that will work best for you. Your first step should be to talk to your doctor. They can then decide if diagnostic imaging is appropriate for you. This will typically start with an x-ray which can reveal stenosis and oftentimes DDD. There are other occasions when more advanced imaging like an MRI is needed to determine the likelihood of a herniated disc. In addition to imaging studies, a doctor can usually determine the cause based on your symptoms. For example, symptom location, frequency, and what makes it better or worse can guide the diagnosis process.

Find relief from Sciatic Pain

There are several approaches to treating back pain and sciatica. One of the most beneficial and conservative approaches to treatment is Physical Therapy. A physical therapist can perform a comprehensive evaluation to determine the cause of your pain which will guide them in developing an appropriate treatment plan individualized for you.

Some of the tools a physical therapist will use to help control your pain are in the form of modalities. Modalities are things like heat, ice, electrical stimulation, and ultrasound. Your physical therapist will also design an exercise program specific to your pain. It is not a good idea to perform exercises that a friend or family member suggests, without having a physical therapist evaluate you first. The reason is that the exercises which are effective in treating one problem, for example, spinal stenosis, are the same exercises that could make another problem, like a herniated disc, worse. In addition to modalities and exercise, various manual interventions like massage, mobilization, and traction can also be used by a PT to address your pain.

In summary, if you or someone you know is experiencing back pain or sciatica you should speak to your doctor in order to determine if a PT referral is indicated.

Kelly Gazey, PT, DPT, treats patients at Allied Services Tunkhannock Rehab Center and Allied Services Wilkes-Barre Rehab Center. Kelly is certified in the McKenzie Method of Mechanical Diagnosis and Treatment (MDT) of the spine. She is experienced in arthritis treatment, injury rehab, joint replacement rehab, orthopedics, and sports medicine.

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