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Learn about sciatica treatment, symptoms, causes and more from the sciatica specialists at Sydney Physio Solutions
What is sciatica?
Officially sciatica refers to irritation of the biggest nerve that runs down your leg (funnily enough named the sciatic nerve). This nerve supplies several of the muscles in your leg as well as the skin around your buttock, the back of the thigh, and a large part of your lower leg.
Commonly, however, the term sciatica is used to refer to any pain referring down into a person’s thigh or leg.
Is Sciatica Dangerous?
It is a fairly common problem and while quite painful, not dangerous. The only time you should be concerned is if you are having difficulty lifting your foot up, noticing some loss of bowel or bladder control, or tinging in the saddle region between your thighs. If you do have these symptoms you should stop reading and go book in with your Doctor immediately. Otherwise, keep reading!
What causes sciatica?
The causes of sciatica are many, however, the two main sources tend to come from the lower back. The sciatic nerve is actually a composite of several nerves that come out from different levels of your lower back vertebra. Each of these nerves exits from a small gap in between two vertebrae called the intervertebral foramen (a complex sounding name but roughly translated means a little hole in between two vertebrae). These nerves all come together to form the sciatic nerve around the same level as the middle of your tailbone.
The two main causes of sciatica result in a narrowing of the space in the intervertebral foramen, or increase pressure on the nerve that passes through.
The first of these is a disc bulge. Your disc acts as a shock absorber between two vertebrae. It consists of a tough outer layer (the annulus) and a gel-like inner layer (the nucleus), similar to a water balloon filled with gel. Over time the annulus can develop micro tears that the nucleus can push into, causing a bulge. This bulge can push out into the nearby nerve squeezing it against the surrounding bone which can then cause sciatica.
The second common cause is often due to arthritic changes in the joints that connect the two vertebrae together. As the joint becomes more worn, it will often become inflamed, and in turn, irritate the nearby nerve. If these arthritic changes have been occurring for a long time, small areas of bone can form on the edge of the joint and can push into the nerve as we move, again creating discomfort down the leg.
What are the signs of sciatica?
There will likely be feeling of discomfort radiating down your leg. The discomfort could be pain, ranging from mild to severe or other nerve symptoms like tingling, numbness, electric jolts or even the feeling of water running down your leg. Sciatica can creep up on you slowly or come from a single episode such as lifting an object, getting up from a chair or even coughing and sneezing.
What is the best treatment for sciatica?
Physiotherapy treatment will often help calm down some of the pain and spasm, and at home heat will often be better for sciatic pain than ice as it calms down the surrounding muscle spasm in your lower back. Talking to your Doctor about appropriate pain relief medication or anti-inflammatories is also a good idea.
The first thing to do is figure out what is causing sciatica. If it is a disc issue, activities like bending, lifting or sitting will tend to make sciatica worse. If this sounds like you some simple back stretches often help. 
Doing 10 repetitions every hour can often ease the pain. This should be done while avoiding aggravating activities such as bending, lifting and sitting. Alternately if bending and sitting feel good, and walking tends to aggravate the pain, then bending stretches will usually be more beneficial. 
Is heat or cold better for sciatic pain?
To help you stop the sciatic nerve from hurting at home follow this procedure. Initially, if the pain is intense a cold pack will help numb the area and reduce inflammation. Heat is used for sciatic pain after the initial pain as it promotes healing through blood flow & relaxes the muscles. The exercises listed above will also help.
Will sciatica go away?
The good news is sciatica is very treatable and will go away. However, it is best to get onto it quickly. The longer you have had sciatica, the longer it will take to fix it.
Unfortunately, reoccurrence rates with sciatic injuries are high unless the underlying causes are addressed and fixed. In either case, once the acute pain has subsided, the best treatment is core strength and fitness-based exercises. This should be done initially with a health professional who has dealt with sciatica before, and then progresses into something you can maintain, be it gym, pilates, yoga or something else.
Remember if you want to prevent sciatica coming back, you will need to keep up with your exercise long term. The only rule is, if you don’t enjoy it, you probably will not keep up with it, so make sure the activity is something you enjoy!
How long will it take for sciatic nerve pain to go away?
The rate at which it improves can depend on how long you have had your sciatic pain. If it is a recent episode (under 3 months), you should be able to make the pain go away in 4-6 weeks. If it has been hanging around for longer than 3 months, the improvements will be slower and likely take several months. If things are not improving within these time frames, there is also the option of seeing a Specialist regarding injections around the nerve to calm it down. In the most extreme cases surgery may also be an option.
If you do have sciatica, remember the best thing to do is get onto fixing it immediately. The longer you leave it, the harder it is to fix. If you do have questions, feel free to give one of our physiotherapists a call on 9252 5770.
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