Physiotherapy for Sciatica in London and Essex

Physiotherapy for Sciatica in London and Essex

Sunday 17th March 2024
Gemma B

Physiotherapy for Sciatica in London and Essex

What is Sciatica?

Sciatica is a clinical diagnosis based on the presence of radiating pain in the leg, with or without numbness and muscle weakness. The sciatic nerve runs from your lower back to your feet. This means the pain may radiate to your bottom, back of the leg and all the way to your feet and toes. It is often described as stabbing, burning or shooting. Symptoms may worsen with twisting, bending, coughing or sneezing.

What causes it?

Conditions that structurally impact or compress the sciatic nerve may cause sciatic. Sometimes it is caused by inflammation around the nerve. This inflammation is part of the body's natural protective system. As the body clears this inflammation the sciatica symptoms usually begin to settle. This will most often occur within a period of 6-16 weeks.

The sciatic nerve is the largest nerve in the body, at up to 2 cm in diameter. Causes may include, but not limited to:

Spinal causes: A traumatic injury, herniated disc (where a soft cushion of tissue between the bones in your spine pushes out of place), spinal stenosis (when the space inside the backbone is too small), spondylolisthesis (when one vertebral body slips with respect to the adjacent vertebral body) and spinal or paraspinal mass.

Non-spinal causes: Leg trauma, pregnancy, pelvic tumour and piriformis syndrome.

Latrogenic causes (causation of a disease, a harmful complication, or other ill effect by any medical activity): Direct surgical trauma, awkward positioning during anaesthesia, injection of neurotoxic substances, tourniquets, dressings, casts or poorly fitting orthotics and radiation.

What is the prevalence?

Annual incidence of 2-34%
Lifetime incidence reported between 13% to 40%
Sciatica peaks in the 5th decade before declining. Sciatica is rarely seen in people aged under 20 years old
Research shows multiple factors can contribute to experiencing sciatica. These include: Being unfit, overweight, smoking and depression

Do I need imaging?

Accurate diagnosis can be made through a thorough clinical exam. The guidelines recommend that imaging is not routinely offered for low back pain with or without sciatica, unless the result is likely to change management such as injection or surgery. Scans may also be ordered if your health professional suspects a more serious spinal conditions.

What can I do to help myself?

The majority of cases of sciatica are best managed conservatively. Here is a short list of things you can do on your own:

  • Carry on with your normal activities. Avoid sedentary behaviours such as prolonged sitting or standing
  • Start gentle exercise as soon as possible
  • Pacing activities throughout the day. Do not try to 'push through pain' because this can make the sciatic nerve more irritated
  • Hot and cold packs may increase comfort. You should speak with a health professional before you use hot or cold packs in the presence of any altered sensation
  • Avoid poor sustained, slumped postures. You may need to talk to your employer/occupational health department to see if any adjustments can be made to help you continue work
  • Use good lifting techniques
  • Stop smoking
  • Maintain a healthy weight
  • If you are limping an assessment for a temporary walking aid can help you feel more comfortable and balanced
  • Sleeping can be challenging but some tips that may help including: Putting a small, firm cushion between your knees when sleeping on your side, or several firm pillows underneath your knees when lying on your back. >Try changing your sleep positions regularly
  • Pain relief medication. Your pharmacist/GP will be able to give you expert advice with regards to the appropriate pain relief medication for you

How can physiotherapy help?

A Physiotherapist can complete an assessment and create a programme that addresses your specific goals. A therapist is likely to create an programme which will likely include a combination of the above treatments, as well as an exercise programme that includes biomechanical, aerobic and a mind-body approach.

Alongside the exercise, your therapist may also consider manual techniques, including spinal manipulation, mobilisation and soft tissue techniques such as massage. Physical and mental health go hand in hand and psychological therapies may complement the work that a physiotherapist can offer.

Medication and therapies can help but there is not usually a 'quick fix', especially in the short term.

What is an epidural injection?

Some people may be offered an injection into the space surrounding the outer covering of the spinal cord, to help to relieve sciatic pain, in the short term. This period of pain relief may allow them to become more active. The injection consists of

• a steroid

• a local anaesthetic or

• a combination of the two

Booking an appointment

If you would like to find out more about Estuary Physios musculoskeletal service, please get in touch with us today and speak with one of our clinicians.

Helpful Resources:

NHS - Sciatica
Patient Info - How to relieve sciatica pain

Other conditions we treat:

We understand that our clients often have a range of medical conditions. Our therapists have a broad range of backgrounds. For example, someone with sciatica may also find they are having difficulty with falls. Please find more informations on falls here:

Parkinsons and Multiple Sclerosis
[Back, Neck and Joint Pain=

Medical Review

The information on this page has been reviewed for accuracy by Barry Ford BSc MCSP, Physiotherapist