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  • Q&A with Australian Health Practitioners

    How is sciatica treated?

    Related Topics
    Orthopaedics Sciatica
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    Neil Synnott

    Exercise Physiologist, Physiotherapist

    I am qualified as a PHYSIOTHERAPIST and ACCREDITED EXERCISE PHYSIOLOGIST.I primarily use the McKENZIE METHOD for assessment and management of musculoskeletal pain disorders. The McKENZIE … View Profile

    Sciatica is pain (and pins and needles) in the leg. Sciatica occurs due to compression of portions of the sciatic nerve which begins at the base of your spine.

    Often there are 'warning' signs prior to an episode of sciatica; these include:

    • tight or achy back for days/weeks prior to the sciatica
    • increased tension in the buttock or hamstring
    • very occasional twinges of pain or tightness in the thigh and/ or calf
    • difficulty or stiffness following sitting for an extended period (>30 minutes
    Thus, the first stage of treating sciatica is to ackowledge and do something about these warning signs!! Visit a physiotherapist/ osetopath/ myotherapist sooner rather than later!

    As sciatica (and low back pain) has a history of being a recurrent problem, understanding how your spine moves and completion of regular physical activity is very important.

    Often restrictions in the lumbar spine slowly compress the sciatic nerve as it exits from the spine. So treatment should almost always include stretches for your back which are specific to you (that is the same stretch doesn't work for everyone!) So everyone needs an individual assessment from a trained health professional - if symptoms have not improved in 3-4 sessions, a second opinion is warranted. A good reference is treat your own back by Robin McKenzie.

    From a McKenzie physiotherapist point of view, a few features are important in treating sciatica:
    • EDUCATION about how your spine works
    • Spinal assessment for discovering what restrictions in the lumbar spine exist
    • Performance of a specific spinal stretching exercise which reduces symptoms and improves spinal movements
    • Assessment and management of sitting posture
    • Development of a trunk/ core stability exercise program
    • When the sciatica is resolved, continued performance of spinal stretching to help prevent a another episode of sciatica!
    This is one method for managing sciatica. Other methods for managing sciatica include medication from your GP, soft tissue massage amongst other.

    Regards, Neil

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    Nathan Smith

    Physiotherapist

    Operate and own a multidisciplinary clinic in Gladstone, Qld, with 7 years in the Private Practice sector. As part of this clinic we have a … View Profile

    In response to this, I think it is pertinent to determine first exactly what ‘sciatica’ is.

    It appears that anyone with pain in the back/buttock and/or into the leg is labelled as having sciatica. As any therapist knows, there can be so many different causes of this from many different structures in the back/butt region. I had a patient recently who had what appeared on presentation to be classic sciatica which was purely a referral pattern from a L5 facet joint. 

    So in answer to the question, to treat sciatica, firstly we need to identify the underlying cause/component and then treat accordingly.

    In my experience, the cause seems to be usually from some disc irritation of the nerve or compression in some cases, some irritation of the nerve close to the piriformis or from the piriformis itself, a facet joint issue and associated referral (including SLT), and/or a trigger point referral (glut med in particuar). 

    All in all, there is no single treatment for sciatica. The way to treat it is to get to your Physio so they can diagnose it properly and then give you the correct advice/treatment/referral.

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    Dr Ali Abdo

    Osteopath

    Ali treats people from all walks of life and a variety of complaints. His interests lie in treating and rehabilitating sports injuries, treating headaches and … View Profile

    Treatment for sciatica is dependant on the cause. A registered Osteopath can help identify the cause of pain with a thorough physical assessment and therefore can determine the appropriate treatment plan for you. The steps followed are generally:

    1. Physical Examination - performed by the Osteopath
    2. Medical Examination - x-ray, CT scan, MRI etc.
    3. Conservative treatment - depending on cause and severity, can be one or a combination of the following:
    • Osteopathic treatment
    • Over the counter / prescription medication
    • Ice / heat pack
    • Physical Activity
    • Injections
            4. Surgical Intervention - Your Doctor may refer you to a specialist if symptoms persist and do not respond to conservative treatment.

    If you feel that you may be suffering from sciatica, get to your local osteopath and they will help determine the cause of your pain and address it accordingly.

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    Josephine Perry

    Bowen Therapist

    Josephine is a fully qualified Bowen Therapist, with full insurance cover and Association membership. Rebates provided by most health funds, according to levels of cover.Practice … View Profile

    Bowen Therapy can ease sciatic pain in one or two sessions.  The gentle, rolling moves over connective tissue stimulate the brain's response, which is to correctly align muscle groups and avoid nerve impingement.

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    Sandra McFaul

    Physiotherapist

    Do you suffer from chronic lower back pain or neck pain? Based in SYDNEY, Sandra is 1 of ONLY 15 Physiotherapists in Australia with ADVANCED … View Profile

    Sciatica can be treated by seeing a McKenzie trained physio.  They are experts in helping people with scaitica pain.

    You will need to avoid some exercises as that will make you sciatica worse.  Not all exercises are helpful. 

    GOOGLE McKenzie method to find out more.

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    Dr Aaron Albrecht

    Chiropractor

    Dr. Aaron Albrecht works at Body Wise Chiropractic in Bibra Lake, Western Australia. The clinic is located within a gym, and Dr. Albrecht is the … View Profile

    Sciatica can be treated in a number of ways, depending on the underlying cause of the condition. In cases of true sciatica, where the nerve is compressed by a disc lesion or other such structural pathology, action must be taken to decompress the nerve. This can be achieved in a number of ways, using flexion distraction to remedy disc bulges is one such method. Where the nerve is compressed by the piriformis muscle, or the symptoms are caused by trigger points in that muscle, the condition is known as pseudosciatica, and responds fantastically to treatments such as dry needle acupuncture, in conjunction with chiropractic adjustments, home stretches, and specific exercises.

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