22 Mar What can you do about sciatica?
When the sciatic nerve becomes irritated it can create pain, pins and needles or numbness down the back of the leg.
Nerves can be compressed, trapped or irritated in a number of ways at the point where it leaves the spine but there is quite a bit of space around the nerve at this point so the chances of it getting pinched here are low. If it does happen the most common of way is where a disc herniates and pushes against the nerve. Whilst this is the most common way for the nerve to become “trapped” it is still only likely to affect 1 in 10 of those suffering from back pain.
A more likely scenario will be where the nerve passes through a damaged or otherwise poorly functioning muscle. Nerves require a good, well oxygenated, blood supply so good, healthy, functioning muscles help this and healthy nerves can be “happily” compressed with no pain in this situation. If we look at the sciatic nerve at worst your leg “goes to sleep” when it gets compressed for long periods by your bodyweight yet you get no pain. Nerves that are starved of oxygen, as when passing through unhealthy or damaged muscle tissue, there will be a reduced blood supply and a reduced supply of oxygen as a result. In these cases the nerve can get cranky and sensitive. When this happens they aren’t going to react well to irritation and compression and will likely cause sciatica like symptoms.
If we assume that there is no disc involvement then one of the things we want may want to use is a mobilisation of the nerve alongside improving the function of the soft tissues that it passes through. The nerve should move slightly in it’s “tunnel” as you can see in the short video below of the median nerve, the median nerve runs from the neck to the hand but the principle is the same.
Along side the treatment for the soft tissues we might want to aid the restoration of the nerves ability to slide and glide. In the video below I show you a simple way to do this. When you are performing the movement you don’t want to create to much irritation if there is a problem. What you want to achieve is movement through as big a range as you can manage without increasing any symptoms you may have so it is ok to perform it with a bent leg if trying to do with a straight leg causes a lot of pain. Another rule is to ease the angle if you are increasing the symptoms distally, that is to say you feel it in your hamstring normally but when doing the movement you feel it in the foot.