The term sciatica describes the symptoms of leg pain—and possibly tingling, numbness, or weakness—that originate in the lower back and travel through the buttock and down the large sciatic nerve in the back of each leg. Sciatica is not a medical diagnosis in and of itself—it is a symptom of an underlying medical condition. Common lower back problems that can cause sciatica symptoms include a lumbar herniated disc, degenerative disc disease, spondylolisthesis, or spinal stenosis.
Spine Disorder
HERNIATED DISC
Spinal discs play a crucial role in the lower back, serving as shock absorbers between the vertebrae, supporting the upper body, and allowing a wide range of movement in all directions. If a disc herniates and leaks some of its inner material, though, the disc can quickly go from easing daily life to aggravating a nerve, triggering back pain and possibly pain and nerve symptoms down the leg. Disc herniation symptoms usually start for no apparent reason. Or they may occur when a person lifts something heavy and/or twists the lower back, motions that put added stress on the discs. Lumbar herniated discs are a widespread medical problem, most often affecting people age 35 to 50.
How can the physical therapist intervene?
Physical therapy offers several interventions to accelerate the healing process. The most effective interventions are vertebral mobilizations and traction .When performing mobilization techniques, the Physical therapy can execute passive movements of the spine and use specific mobilizations to stretch the joint capsule and allow for a better quality of movement. The therapist can also prescribe different exercises meant to increase trunk movement, stretch the capsule, increase the strength of the core stabilizers and improve posture. Other methods can be employed, such as the use of TENS or interferential current for pain management and neuro-proprioceptive taping to improve movement quality and reduce pain. In many cases, Physical therapy treatments are also combined with Dry Needling to help stretch capsule fibers and relieve pain. Combining these two methods increases the patient’s chances of having a speedy recovery.
DEGENERATIVE DISC DISEASE
Degenerative disc disease describes the symptoms of pain and possibly radiating weakness or numbness stemming from a degenerated disc in the spine. There is minimal blood supply to the disc, and blood is what brings healing nutrients and oxygen to damaged structures in the body. This means that the spinal disc lacks any significant reparative powers. While the definition sounds simple, many patients diagnosed with degenerative disc disease are left wondering exactly what this diagnosis means for them. While it is true that the disc degeneration is likely to progress over time, the pain from degenerative disc disease usually does not get worse and in fact usually gets better given enough time.
SPINAL STENOSIS/ SPONDYLOSIS
Stenosis means the abnormal narrowing of a body channel occupied by the spinal nerves or the spinal cord. A few do not feel any effects of the narrowing, but as part of the aging process, most people will eventually notice radiating pain, weakness, and/or numbness secondary to the compression of the nerves or spinal cord. Lumbar spinal stenosis most often occurs at the L4-L5 and L3-L4 levels, it can occur any level in the spine. The degenerative cascade may eventually affect most of the vertebral segments of the lumbar spine.
LUMBAR SPRAIN
Lumbar sprain is a blanket term for all lower back problems that do not involve nerve damage. Low back muscles, ligaments and joints can be affected by a false movement or poor posture. 70 to 80%¹ of North American’s will suffer from this condition at some point in their lives. To ensure quick and proper recovery, physical therapy should be started within the first 90 days². In fact, the treatment of choice for low back pain is physical activity, and your physical therapist can help you choose the best exercises and treatment plan.