Back pain is the second most common symptom-related cause of physical therapy in the United States. Up to 84% of adults have low back pain at some point in their lives, and sciatica can affect up to 40% of patients with low back pain. The long-term outcome of low back pain is usually beneficial, but persistent symptoms affect millions of people. About 5% of people with sciatica have a disability and up to 75% of the costs associated with low back pain. Non-invasive interventions, such as physical therapy, are an important tool that can play an important role in reducing healthcare costs.

What is sciatica?

The term sciatica describes the symptoms of leg pain – possibly stinging, numbness or weakness – that originate in the lower back and travel through the buttocks and along the large sciatic nerve at the back of the leg.

Sciatica is not a medical diagnosis – it is a symptom of a potential medical condition, such as lumbar disc herniation, degenerative disc disease or spinal stenosis. Sciatica is usually characterized by one or a combination of the following symptoms:

• Pain only on one side of the hips or legs [several legs occur]
• Pain is more serious when sitting
• Leg pain is often described as burning, stinging or burning [as opposed to dull pain]
• Move the weakness of the leg or foot, numb or difficult
• Severe pain can make standing or walking difficult

How to treat symptoms of sciatica caused by low back pain

1. Ultrasound: Ultrasound is often recommended before stretching the piriformis. Ultrasound is a form of deep heating in which sound waves are applied to the skin and penetrate into the soft tissue. Ultrasound is especially useful for relieving acute exacerbations of pain and enhancing tissue healing.
2. TENS: TENS, or transcutaneous electrical nerve stimulation, is a form of back treatment that uses low-pressure currents to relieve pain. TENS is effective for treatment because it causes local release of neurotransmitters such as serotonin, which blocks pain signals in the brain.
3. Iontophoresis: Iontophoresis provides a method of transdermal delivery using low DC currents to drive it to low back related tissues. Typically, it is used to administer anti-inflammatory drugs to local tissues. The second benefit of iontophoresis is that the current itself can immediately relieve symptoms by blocking the pain receptors.
4. Traction platform: The lumbar traction using the traction table operates under the following theory: the separation of the lumbar spine will reduce the impact of the spinal nerves and reduce the pressure between the intervertebral discs.
5. Low-level laser therapy: Low-level laser therapy helps relieve muscle tension, cramps, inflammation, fluid retention, pain, stiffness and pain. Other benefits of LLLT include improved circulation [blood and lymph], general flexibility, range of motion, and increased tissue elasticity [eg, scar tissue]. In a study published in the Australian Journal of Physical Therapy, the results showed that low-intensity laser therapy combined with exercise can significantly reduce pain and increase the range of lumbar motion in patients with severe low back pain.

Low back pain is the price of health care and personal care. When untreated, low back pain can continue to cause further problems, such as sciatica, which increases its adverse effects. Physical therapy is a time- and cost-effective way to combat the effects of sciatica and low back pain and help patients recover from painless life.

How physical therapy treats sciatica caused by low back pain was originally published on Spring