Back
Sciatica
Sciatica is a term used to describe the symptoms of leg pain, tingling, numbness, or weakness that travel down the lower back via the sciatic nerve. There are many causes of sciatic pain; herniated disc, spinal stenosis, degenerative disc disease, and spondylolisthesis
What does It feel like?
• Pain - A constant burning sensation or a shooting pain starting in the lower back or buttock and radiating down the front or back of the thigh and leg and/or feet.
• Numbness - In the back of the leg. Sometimes, tingling and/or weakness may also be present.
• One-sided symptoms - Generally affects one side of the leg.
• Posture induced symptoms - Sciatica symptoms may feel worse while sitting, trying to stand up, bending the spine forward, twisting the spine, lying down, and/or while coughing.
Causes:
• Disc degeneration or trauma can cause the nucleus to herniate through to outer disc and leak out of the annulus fibrosus into the spinal canal. Annulus fibrosus is directly underneath the spinal nerve root, so a herniation in this area can put direct pressure on the nerve, in turn causes sciatic symptoms
• Spinal stenosis occurs when the spinal cord is compressed by narrowing of the canal. Spinal stenosis is related to degeneration of the spine so is often found in the older generation, however it can be a condition a person has from birth
• Degenerative disc disease most commonly occurs in the cervical spine (neck) or the lumbar spine (lower back). It is known as ‘wear and tear’ and can be caused by general day to day, repetitive movements. There is no cure for this condition, however symptoms can be eased by physical therapy, massage and mobilisation techniques can help.
Treatment:
• Physical therapy and corrective exercises, along with massage and mobilisations, can help to relieve symptoms.
Sciatica is a term used to describe the symptoms of leg pain, tingling, numbness, or weakness that travel down the lower back via the sciatic nerve. There are many causes of sciatic pain; herniated disc, spinal stenosis, degenerative disc disease, and spondylolisthesis
What does It feel like?
• Pain - A constant burning sensation or a shooting pain starting in the lower back or buttock and radiating down the front or back of the thigh and leg and/or feet.
• Numbness - In the back of the leg. Sometimes, tingling and/or weakness may also be present.
• One-sided symptoms - Generally affects one side of the leg.
• Posture induced symptoms - Sciatica symptoms may feel worse while sitting, trying to stand up, bending the spine forward, twisting the spine, lying down, and/or while coughing.
Causes:
• Disc degeneration or trauma can cause the nucleus to herniate through to outer disc and leak out of the annulus fibrosus into the spinal canal. Annulus fibrosus is directly underneath the spinal nerve root, so a herniation in this area can put direct pressure on the nerve, in turn causes sciatic symptoms
• Spinal stenosis occurs when the spinal cord is compressed by narrowing of the canal. Spinal stenosis is related to degeneration of the spine so is often found in the older generation, however it can be a condition a person has from birth
• Degenerative disc disease most commonly occurs in the cervical spine (neck) or the lumbar spine (lower back). It is known as ‘wear and tear’ and can be caused by general day to day, repetitive movements. There is no cure for this condition, however symptoms can be eased by physical therapy, massage and mobilisation techniques can help.
Treatment:
• Physical therapy and corrective exercises, along with massage and mobilisations, can help to relieve symptoms.
Spondylosis, Spondylolysis & Spondylolisthesis
Spondylosis (vertebral arthritis)
… is a painful condition of the spine resulting from the degeneration of the intervertebral discs.
Spondylolysis (pars interarticularis Defect)
… refers to the separation of the pars interarticularis (a small bony arch in the back of the spine between the facet joints). Spondylolysis can occur in children between the ages of 5 and 10. It is sometimes called the “gymnastics fracture” because it is associated with sports that require a lot of bending backwards - Symptoms include a deep ache in the lower back, pain that is worse with movement, and tightness in the hamstrings. If the vertebral slippage is severe, nerve roots can be compressed. Most people do not experience symptoms from lumbar spondylolysis at all, and those who do tend to develop problems in adulthood or in adolescence.
Spondylolisthesis (vertebral slipping)
… is a condition in where a vertebra slips forward over the one below. Spondylolisthesis is a common cause of lower back pain and leg pain in younger adults (age 30 to 50). The most common level it is found is at L5-S1, although it can occur at higher levels.
Symptoms:
• Lower back pain (deep ache)
• Pain that radiates into the buttocks and back of the thighs
• Pain that is worse when standing/ walking
• Pain that feels better with sitting - especially sitting in a reclining position
• A tired feeling in the legs, and possibly leg numbness or tingling, especially after walking
Ankylosing spondylitis (AS)
Ankylosing spondylitis (AS) is a type of arthritis that affects the spine. The disease is illustrated by inflammation and resulting in stiffness and pain in the joints along the spine.
The inflammatory condition results in parts of the vertebrae and joints fusing together. As parts of the vertebrae grow (or "fuse") together, the spine becomes more rigid and inflexible. Range of movement of the spine will diminish over time due to the fused bones causing stiffness. This, in turn affects the elasticity of soft connective tissue. Often, the first symptom of ankylosing spondylitis is sacroiliitis, or inflammation of the sacroiliac joints at the base of the spine.
This inflammation can cause buttock pain that radiates into the thigh and/or diffuse lower back pain. The sacroiliac joints can eventually fuse together, limiting mobility.
Ankylosing spondylitis common young men between the ages of 15 and 30, although it can affect anyone. Almost everyone with ankylosing spondylitis carries a specific gene called HLA-B27. Therefore, a blood test my be required to gain a full diagnosis.
Microfracture can be found the thoracic region of the vertebra, leading to a shortening of the front of the spinal column and resulting in a hunched forward posture, called excessive kyphosis
Treatment:
• Medications - Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Physical therapy – to help with pain reduction, and improve mobility of the spine.
• Massage and mobilisation techniques
• Lifestyle changes –
• Stay active.
• Apply heat and cold. Heat applied ease pain and stiffness. Try Ice on inflamed areas can help reduce Swelling.
• Don't smoke. If you smoke, quit.
• Practice good posture.
|
Degenerative Disc Disease
Degenerative disc disease refers to the "wear and tear" or changes to a disc which can be caused by aging so generally effects older people. It has been notes that signs of degenerative discs can be worsened if a clients has had pervious injury, has had a repetitive job or hobby, hereditary. Sometimes, narrowing of the space between discs can occur and cause bone spurs this can lead to compression of nerve roots
Symptoms:
Sometimes, no symptoms are present with this type of condition however pain can be felt:
• Pain and Stiffness
• Pain is worsened when moving the neck
• Numbness, tingling and Weakness down the arms
Diagnosis:
• Reviewing medical history
• Assessment
• X-ray
Treatment:
• Ice/Heat
• Physical therapy
• Steroid injections
• Soft tissue treatment (relax surrounding structures)
• Surgery
Osteoarthritis (Back
Osteoarthritis also none as facet joint syndrome can be common in the older population. Cartilage between the facet joints can wear down over time, causing pain and restriction. Localised pain to one area of the neck is also common, however it is not uncommon for the arthritis to spread.
Diagnosis:
• Medical history
• Physical examination
• MRI
• X-ray
Treatment:
• Ice/Heat
• Rest, reduce or modify activity
• Anti-inflammatory
• Physical therapy
• Massage therapy
Herniated Disc
A herniated disc can occur to anyone, but is more common in older adults. The nucleus which is inside the disc can ‘leak’ or escape and can pinch or compress the nerve.
Symptoms:
• Burning or tingling pain down the arms
• Weakness
• Numbness
• Muscle Spasm
• Stiffness
Diagnosis:
• Medical history
• Physical examination
• MRI
Treatment:
• Ice/Heat
• Anti-inflammatory
• Physical therapy
• Massage therapy
Piriformis syndrome
The Sciatic nerve can compress on the Piriformis muscle and causes pain deep in the buttocks which radiates down into the leg. The condition can be caused by overuse which can cause the piriformis to go into spasm, compressing the nerve
Symptoms:
• Tenderness and pain deep in the buttock muscles.
• Pain may radiate down the back of the leg into the hamstring muscles
and sometimes even into the calf area.
Treatment:
• Massage
• Ultrasound Therapy
• Acupuncture
• Stretching
• Strengthening exercises
• Dry Cupping
Sacroiliac Joint Pain (SIJ pain)
SIJ pain is common, yet can be under recognised. The SI joint can become irritated and dysfunctional due to injury or posture. This can then lead to can or discomfort.
Symptoms:
• Sharp, stabbing, or dull ache located in the lower back or hip area
• Groin pain can also be felt along with thigh and knee pain
• Pain can be worsened when the joint is stressed such as standing or walking
Treatment:
• Massage
• Mobilisation techniques
• Stretching
• Strengthening exercises
• Acupuncture
• Ultrasound Therapy
