Monday, May 28, 2018

PT Pathologies: Sciatica from a Herniated Disk

The term sciatica or in medical terms,  lumbar radiculopathy, describes the symptoms of leg pain.  The symptoms of sciatica can include tingling, numbness, and weakness starting in the buttocks and possibly running its way down the back of the leg.  Most commonly sciatica pain resorts from nerve roots between L4 and S1. The pressure put on the nerve can cause irritation to the lumbar nerve root causing the tingling, numbness, and weakness in the leg.  The sciatica pain secondary to a herniated disk is caused by disk material protruding backwards and irritating or compressing a nerve root.  This causes the radiating pain down the leg.
     
        The pain is typically in the lower back and running down the back of the leg.  The best way to get temporary relief from the pain is to get into an extended position.  Lying in a prone position and using your hands to push up is the best extension exercise prescribed for a patient suffering from sciatica.  Begin by holding the stretch for five seconds and eventually work up to holding the position for thirty seconds.  Once pain is localized into the lower back the goal is to strengthen the back and the core as a whole.  One exercise that works the lower back and abdominals would be the plank.  Begin by holding the plank for fifteen seconds and begin to progress from there up to a minute hold.  Using curl ups and opposite hand opposite leg or also known as birddogs are great exercises to work the core and lower back to begin to strengthen the weak area.   Therapy is very beneficial for patients suffering from sciatica secondary to herniated disk.  Pain can be chronic and progressive if proper therapy is not pursued.  Once the patient has managed the pain and strengthened the weak portion of the back and core it is important to teach the patient how to prevent this in the future.

In Summary:
  • The sciatic nerve experiences an inflammatory response and subsequent damage secondary to compression from the herniated disc.
  • Sciatica is characterized by low back and gluteal pain that typically radiates down the back of the thigh along with sciatic nerve distribution.
  • Pin will increase in a sitting position or when lifting, forward bending or twisting.

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