Sarah key explains all you need to know about sciatica symptoms and treatment

Sciatica symptoms and treatment can be confusing. People are often fazed that pain in the leg can be caused by something wrong in the back. Even so, acute and chronic sciatica feel very different.

Acute sciatica is often reported as a searing, red-hot pain through the leg, often associated with numbness and pins and needles. Chronic sciatica feels more like an ache, a pulled muscle, or is if a string has been pulled too tight in the calf.  

With acute sciatica, the straight leg raise (SLR) test is positive, meaning that it is impossible to lift the leg straight off the bed without severe discomfort. Most sciatica however is chronic and the straight leg raise is negative. This is not to say however, that both hamstrings and the gluteal muscles will not be tight (from raised tone) if your back is bad. 

Sciatica symptoms in the leg are often associated with strange 'other' sensations such as a pebble in your shoe, a feeling as if the lower leg is wet, or that ants are crawling up your leg. These symptoms do not usually occur with neurological signs such as absent reflexes or muscle weakness. Broadly speaking, each different spinal level refers sciatica symptoms to different parts of the leg. The further down the leg symptoms spread, the greater the noxious inflammation of the source spinal structure. 

Sciatica Treatment

Sciatica Treatment is Different in the Acute and Chronic Stages

Acute Sciatica Treatment

1. With acute facet joint inflammation the aim of treatment is to disperse swelling and reduce capsular engorgement. The trapped swelling is painful  (think of a sprained ankle) but retained inflammatory chemicals also irritate the nerve.

Pressure of knowing hands helps evacuate excess joint fluid. The local touch may also reduce local spasm of the deep spinal muscles - multifidus -  thus reducing their compressive clench on the inflamed spinal joints. The hands have it!

2. Home treatment for acute sciatica focuses on reducing muscle spasm and relieving facet engorgement. This is a tricky phase and you can't afford to rush things. (Being too gung-ho can make the spine close and lock you out, causing more pain.) In Brief Back Pain Treatment Videos for The Time Poor there is a short clip of Sarah showing you how to use your own hands. Not easy but it can be done.   

Chronic Sciatica Treatment

1. For treatment in the chronic phase, mobilising with the heel is ideal as it's far more effective than hands. The heel creates a bigger vascular response to float the nerve off the adhesions, thus making it easier for the sciatica stretches to work. Pedal pressures are deeper and 'broader' but much less painful. 

2. Spinal decompression using a BackBlock is important in sciatica relief. The passive hyper-extension pulls the spinal cord and the nerve roots upwards in the spinal canal, which coaxes the nerve root free where it is embedded in adhesions. It may cause temporary tingling in the feet but don't panic! Here again, you can't afford to rush things. Nerve tissue doesn't take kindly to being stretched.