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The sciatic nerve is said to be as thick as your little finger. It starts from the lower lumbar spine and passes through the buttock region, between the hamstrings (muscles on the posterior thigh), into the back of the knee and the foot. It supplies the skin, muscle, joints and blood vessels to the leg.

What symptoms will I have?

The symptoms in the leg are often described as an acute ‘shooting’ pain or an ‘electric shock’. You might also experience altered skin sensation, changes in skin temperature and weakness of the muscles in the lower leg.

What should I do?

Seek the help of a physio for a diagnosis and advice. If you are experiencing weakness and severe pain in your leg, then see your GP urgently. A small percentage of people experience bladder disturbances and loss of sensation around the pelvis. If you do, seek medical help urgently.

What causes sciatica?

Most commonly the sciatic nerve is compressed as it exits the lower nerve roots in your lower back by a disc prolapse. There are other causes, but these are in a minority.

Will the sciatica improve over time?

Yes. Sciatica improves over several months, but some people (20-30 per cent) continue to have problems. The body is amazingly robust and with time it will improve with conservative measures.

Will surgery help?

A recent review of the best evidence showed no difference between patients who had surgery or conservative management at one year, surgery gave faster pain relief, but long-term outcomes were the same. Some people need surgery but the surgeons are reluctant to operate and advise rehabilitation first unless there is bladder or bowel disturbance or associated weakness.

What should I do?

Keep active and see your GP for analgesic medication. Relative rest in the acute stage (first few days) is necessary, but try to walk, remain active and modify your normal activities.

Will physiotherapy help?

We see many people who have passed through the acute stage, but their symptoms persist. There are many reasons for ongoing problems, but if you continue to limp or use your spine in an abnormal way the compression on the nerve might continue. Pain causes us to keep still and ‘brace’ the muscles around the back. This causes further compression.

Don’t live with sciatica – come and see what we can do at the Hallamshire Physiotherapy clinic.

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