By Michael Hall
“Sciatica.” Just saying the word is enough to send shivers down your spine! It is certainly a condition that you wouldn’t wish upon anyone. The pain can be excruciating, bringing people to their knees and making even the simplest of tasks such as getting out of bed or going to the toilet, unbearable. As the name implies, sciatica refers to an ache or pain, tightness, numbness and/or pins and needles along the pathway of the sciatic nerve or its branches Most commonly it is felt in the buttock and may extend down the back or side of the leg into the calf and sometimes the foot. It is thought to be due to irritation of the sciatic nerve anywhere along its course, whether it be from the inter-vertebral disc or as it winds its way around bones and through muscles.
How sciatica is differentIn truth, any tissue in the lower back and buttock can refer pain down the leg. The greater the severity of the irritation, the further down the leg, pain is referred. What differentiates irritation of the sciatic nerve from these other structures is the quality of the pain and discomfort. Often referred to as “radicular” pain, it is frequently described as a sharp, constant, throbbing “toothache” type pain and is commonly experienced in the calf. It is the unrelenting nature of the pain that can interrupt sleep and interfere with almost every aspect of life, gradually wearing down even the most stoic person to become a depressed, gibbering mess. Whilst irritation of the sciatic nerve will lead to pain, direct pressure will cause other signs and symptoms such as pins and needles, numbness, loss of reflexes and in severe cases loss of strength and sometimes the inability to lift the foot (called foot drop). These are medical emergencies, and in such cases one should immediately consult with their doctor for referral for medical investigations (such as a CT or MRI scan) and to an appropriate specialist.
So where do you start on the road to recovery?The first thing to do is to undergo a comprehensive subjective assessment and physical examination. This will help to determine what the structural source of the problem is, what the cause is, how bad it is, how it is progressing. The examination and other investigations will also direct what the most effective treatment might be. For example, if there is an inflammatory component, cold packs, anti-inflammatory medication or creams, anti-inflammatory “food” along with avoidance of the aggravating postures and/or movements, might be appropriate in allowing the inflammation to reduce. Where it is difficult to avoid these aggravating positions and movements, taping and bracing are often very helpful in protecting the area against further irritation, aggravation and flare-ups.
Once the inflammation has receded, healing can be promoted through the use of deep heat, electrotherapy along with soft tissue release, dry needling, joint mobilization or manipulation and neural freeing up techniques. By reducing tissue tension and promoting nutrient and oxygen metabolism, these techniques and modalities help to optimize the environment so that the best, fastest and most complete repair can take place.
What is the most effective treatment?It is a commonly frustrating occurrence for many people to experience relief with treatment, only to walk out the door and for the signs and symptoms to return. This short term, “yo-yo” experience of relief is characteristic that only the symptoms of a problem have been addressed, whilst the real causes of the problem have not been dealt with. People often don’t understand that “hands on” techniques or machine type electrotherapy whether it be performed by a physiotherapist, osteopath, chiropractor, massage therapist, and even acupuncturist, will only produce short term biomechanical and biochemical changes. These changes will quickly revert back to their original state, leading to a return of the signs and symptoms unless the causes of the problem are corrected.
However, if “hands on” and electrotherapy modalities are followed by precise, corrective exercise, then often the benefit of the exercise is enhanced, making it even effective in producing a better, faster result.
Furthermore, if this precise, corrective exercise is then integrated into postural and functional movement patterns, the gains achieved through this rehabilitative exercise is then taken up in everyday activities, further accelerating improvement and protecting against the possibility of re-injury.
How do I achieve long lasting relief?To achieve long term, sustained relief, the strength and conditioning phase of treatment must be progressed to train for stresses above and beyond the demands of everyday life, so that a reserve capacity is created. It is not good enough that a person achieves the physical status they had prior to the injury; after all it was with this capacity that they sustained their problem. At Bodywise Health, our aim is for your physical conditioning to be 20% better following your recovery to what it was prior to the occurrence of the problem, so that you will have 20% capacity in reserve. This gives you a safety net and helps to ensure that you will never suffer from that particular problem again.
Finally, it is imperative that you are not only taught how to prevent your problem from re-occurring, but even more importantly, how to continue to improve in your own conditioning, functioning and performing of all every day physical tasks. After-all, at Bodywise Health, we believe that whilst recovering from an injury might be the end of treatment, even more significant is that it is the starting point of a life free of pain and limitation and all the possibilities that this brings. It is an incredible opportunity and one that we encourage you to grasp with both hands. You will have the complete resources of Bodywise Health behind you, supporting, encouraging and coaching you every step of the way.
For more information or for an appointment, please call Bodywise Health on 1 300 263 994.
• Rebates are available through your private insurance extras cover;
• For complex or chronic conditions, you may qualify for the EPC (Enhanced Primary Care Program) allowing you to receive 5 allied health services each calendar year with a referral from your GP. For more information, please call Bodywise Health now on 1 300 263 994.