Many times in the clinic, patients will claim they have sciatica. In reality it is a different pathology. Because of the popularity of the word “sciatica”, people think any type of back pain equates to sciatica. However, this is not true. In general, back pain can be a result of many different things. But how do you know if it’s sciatica? Let’s find out.

Sciatica is the inflammation of the sciatic nerve. This particular nerve innervates a large portion of the leg, therefore when inflamed can be very painful. Usually it is one leg or the other, but sometimes both can be affected. The usual distribution of pain starts in the back and radiates down the leg. It can start off as being mild in pain and only affecting the buttocks, but it can become severe pain and radiate down the entire backside of the leg. Sometimes, numbness occurs. If the pain is localized and not traveling down the leg, it is most likely not sciatica. There is also a muscle (piriformis) that the sciatic nerve runs above, through, or under (depending on the person’s anatomy). If this muscle has a pathology, the sciatic nerve most likely will also be affected.

There are multiple treatments for this condition. I will go over the top things I personally do in the clinic.

• Dry Needling – This technique helps facilitate nutrients to the nerve and also helps with relaxation of the inflamed muscles around the nerve
• Piriformis Stretch – There are multiple ways to stretch out this muscle, the top stretches I prescribe are figure-4 or pigeon stretch.
  • Figure-4 stretch: on your back with bent knees, bring one ankle to the opposite knee, now either put your hands behind the knee that the ankle is on and pull towards your chest (could use a towel if need be) or push down on the knee that is opposite of the one the ankle is on. Hold position for 1 minute.
  • Pigeon stretch: start in a pushup position, now bring your knee to your opposite shoulder, now drop your body weight into the floor and you should feel a pull in the buttock area. Hold position for 1 minute. If there is any increased pain anywhere with either of these stretches, stop immediately.
• Sciatic Nerve Glide – Begin by sitting on the edge of a surface, now start in good posture looking towards the floor and toe pointed down, now look up towards the ceiling while simultaneously pointing toe up towards yourself. Complete this motion 30 times.

These are a few things that can help with sciatica, but if your condition worsens or what you have is not sciatica (but still have pain) come see us at Jones Physical Therapy.

Garrett Dinicola PT, DPT