Treating Sciatica and Back Pain

One in eight people in the UK will be affected by back pain at some point in their lives. It is the most common single cause of disability in the UK, with lower back pain accounting for 11% of total disability of the UK population. Sciatica is a painful condition caused by compression or irritation to the sciatic nerve, which runs from your hips to your feet. The condition affects the lower back, bottom, backs of the legs and feet, and although it can be very painful it usually gets better by itself within four to six weeks (although it can last longer). 

Causes of sciatica

Sciatica is normally caused by injury to the muscles or ligaments around the sciatic nerve which results in inflammation and irritation of the nerve root. Spinal stenosis, which is narrowing of the tunnel that the sciatic nerve passes through, and a slipped disc pressing on the nerve root can also cause sciatic pain.

Sciatica symptoms

Sciatica produces a burning, stabbing or shooting pain in the lower back and buttocks, which may travel down one or both legs. It can be accompanied by weakness in the leg or numbness which may go down as far as the foot. Patients sometimes also experience pins and needles. Sciatica is not normally the sign of a more serious problem, however you should seek urgent medical help if you experience:

• Problems passing urine
• Losing control of bowel movements
• Numbness around your bottom, buttocks or between your inner thighs
• Worsening weakness or pain in both legs
• Erectile problems

Diagnosing sciatica

Normally a physical examination by a doctor is sufficient to diagnose the condition but you may require an MRI scan if your symptoms fail to improve within six weeks or if you are experiencing a worsening of symptoms, such as weakness or numbness of the legs or bladder control problems.

Treatment of sciatica

You will normally be able to manage sciatica symptoms yourself at home. Avoid sitting or lying down for long periods and continue with your normal activities as much as you can. Regular back stretches can help, as well as gentle exercise, such as swimming or yoga, that gets your back moving. Painkillers, anti-inflammatory medication and heat packs can also help to relieve the pain. Some studies suggest acupuncture and TENS machines may provide relief.

However, if the condition fails to respond to at home treatment within a few weeks or is getting worse you should visit a doctor who will be able to recommend an effective treatment approach.

Ultrasound guided (Spinal/Epidural) injections for sciatica

Ravenscroft health provides physiotherapy services, along with other types of musculoskeletal treatment. In a small number of cases, if pain persists longer than would normally be expected or loss of mobility is significant, its consultants may recommend using ultrasound-guided injections to treat sciatica. The idea is to provide a window of pain control that will allow the patient to exercise and reduce irritation on the sciatic nerve so that they can recover properly. Ultrasound/X-ray guidance is used to ensure accurate positioning of the injection to provide maximum pain relief. 

Once sciatic pain has been treated successfully, physiotherapy can be very effective at strengthening core muscles to reduce the risk of further episodes of sciatica. 

Learn more about the ultrasound-guided epidural injections we offer.

Managing back pain

Although it may be tempting to think you need to rest if you have back pain, it’s actually important to remain as active as possible. Stretching and gently exercise will help and you can take anti-inflammatory medication and use heat packs or cold compression for short-term pain relief. 

Most back pain will clear up by itself within a few weeks but if it continues for longer or is getting worse or you are finding it difficult to do day-to-day activities, seek medical help. You may be offered manual therapy treatments, group exercise classes or psychological support if you are struggling to cope with the pain.