Sciatic nerve pain / Sciatic nerve syndrome / Sciatica
Rehab training for the injury
Description of sciatica
Sciatica syndrome is perhaps one of the most well-known conditions at all, and yet relatively rare. The problem is probably that both doctor, therapists and patients mix the concepts together, because a sciatica has exactly the same symptoms as the more frequent condition, called piriformis syndrome. Sciatica has also similarities with nerve pinching in the back such occurred because a disc herniation. However, it is therapeutically very important to know the difference between the different concepts, because even though there are many similarities, the conditions are different and therefore they must also be treated completely differently if the symptoms have to disappear.
The difference between piriformis syndrome and sciatica, which is completely similar in terms of symptoms, occurs piriformis syndrome when the muscle becomes thicker due to overload (hypertension) and presses on the nerve (sciatic nerve). Sciatica is a condition. where the nerve has become too short, normally because of lack of movement/exercise. Both conditions will, affect the nerve in the same way, and give increased sensitivity, irritation and tingling along the nerve. However, there may be a small variation in the symptoms of the two conditions, as a piriformis syndrome often only causes sensitivity changes down to the knee area. Sciatica most often radiates along the entire nerve pathway. If the conditions come from a nerve pinch in the back, the radiation can be simpler, however it depends on which segment (vertebral area) is pinched. Here, the sensitivity changes will follow some completely different nerve branches, and most often give more belt-shaped radiation down the leg, in which we call a dermatome.
Those affected by sciatica are most often people who have a very sedentary job. Here is the hips and knees normally bent and the ankle is stretched slightly over a longer period. It could typically be someone driving a taxi, truck driver or office workers. And at the same time, you have a very inactive life, where you neither play sports nor move enough. When you hold your legs in that position, all the structures in the legs will be very relaxed, and over time all the tissue contracts because it is not used. This applies to both muscles, tendons, ligaments and nerves. The sciatic nerve is the largest nerve that goes down the leg and when you stand up it has a certain stretch, and even more if you take a step (bent hip, stretched knee and lift your ankle). The problem is that if you have shortened your structures down in the leg, by being inactive and keeping your legs in the aforementioned position over a longer period, the nerve is simply not long enough when you stand and this gives you even more symptoms when you walk, especially up of pins, or when rising from a sitting position. In the beginning, symptoms can start with minor irritation in one leg when driving for a long time. When the nerve is stretched out, one will experience increased sensitivity down along the nerve.
Although the condition can be very bothersome, but it is relatively easy to treat.
Symptoms of sciatica:
- Radiation down the back of the thigh, the outside and front of the lower leg, the outside and the front of the foot.
- The symptoms worsen if you get up from a sitting position, ascend the stairs or drive a car for a long time.
- The symptoms decrease if you exercise, ex. jogging or running.
Examination of sciatica syndrome:
- The history of sedentary and inactive lifestyle.
- Test af iskias ved at lave forskellige stræk på nerven.
- Exclusion of back and hernation in the lumbar spine.
Treatment of sciatica:
- The therapist can do so-called PNF stretching; which stands for proprioceptive neuromuscular facilitation (PNF), and is an advanced form of stretching where you also do contraction in the muscle while stretching relatively quickly in the bite tissue.
- Cryotherapy before the treatment (ice massage for 9 min).
- The patient shall do specific stretching exercises (see here under rehab).
- Start doing some form of exercise if you have very sedentary work.
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