Physiotherapy for Back pain and Sciatica

Physiotherapy for Back pain and Sciatica

Back pain and sciatica are often confused with one another. Sciatica is one of the many causes of back pain, numbness, and radiating pain along the sciatic nerve. The sciatic nerve travels through the lumbar region of the back and down to the leg covering the full length of the body. Sciatica causes lower back pain that usually travels to the buttocks and legs. Sciatica pain is sharp and searing. It is complicated and requires special skills for diagnosis. Sciatica is often mistaken for any low back pain or radicular leg pain.

Back Pain

Back pain can be found anywhere in the spinal region of the body - lower, upper or middle. It can be caused due to poor posture, a motor vehicle accident, or improper lifting technique. A physical therapist diagnoses the cause and type of back pain and analyzes its development in addition to the location and your medical history.

Sciatica

While back pain is acute pain, sciatica is more spread out and radiating that traces the sciatic nerve in your body. When the sciatica nerve becomes inflamed or compressed, it causes a searing pain that shoots from your lower back to your buttocks, legs, and feet. It may be accompanied by radiculopathy which is radiating numbness in a specific part of your leg.

Type of Physical Therapy and Exercises

Once a physical therapist conducts a comprehensive analysis of the type and location of the pain, a customized plan is laid out for the patient catering to their personalized needs. Physical therapy may be used in combination with manual therapy, soft tissue mobilization techniques, and other therapies.

• Exercise

Physiotherapists use exercises that promote healing and expedite pain relief. Extension and flexion back exercises are used to facilitate the movement of the spine. Often people suffering from back pain or sciatica feel relief with a directional movement of the spine. The direction varies from person to person depending on the underlying cause of sciatica. These exercises are tailored according to the individual’s needs by the physiotherapists after a thorough pain assessment. These exercises include extension and flexion, i.e. backward and forward bending.

The McKenzie Method involves a series of directional movements that help in the diagnosis and treatment of pain affecting the spine, muscles, and joints. The technique focuses on mechanical movements that move the radiating pain closer to the center of the body through exercises. The basis of this method is centralizing pain causes improvements in symptoms and aids in pain relief.

Bodyweight and resistance exercises help in strengthening the abdomen and core muscles. Isometric exercises involve contracting muscles without the movement of joints such as planking or a bridge hold. They strengthen the abdomen muscles when the pain is acute. Isotonic exercises increase muscle strength to enable load-lifting such as resistance bands and weight training. Functional retraining exercises are used to re-educate muscles to facilitate a free range of motion while lifting, carrying, bending, or squatting. Physiotherapists teach the proper technique and healthy movement patterns to reduce the risk of a new injury or worsening of the old injury.

• Nerve Mobilization

Nerve glides involve active and passive techniques on the affected nerve with varying pressure and tension to facilitate movement in restricted joints and inflamed muscles. It promotes healing and reduces symptoms associated with back pain and sciatica.

• Joint Mobilization

Joint mobilization is a manual therapy that entails a physical therapist applying varying pressure to a restricted joint resulting in mobilization and free range of motion while providing a therapeutic effect.

Joint manipulation is a manual therapy technique in which therapists apply a quick, thrusting force at the end range of motion to aid pain relief and facilitate mobility.

• Dry Needling

Dry needling involves a certified healthcare professional using small stainless steel needles and penetrating them at trigger points in the muscles. This technique is used to release hyper-contracted muscle tissue and break knotted muscles to facilitate pain relief.

• Muscle Energy Technique

Muscle Energy Technique or MET is a manual therapy in which the therapist performs gentle muscle contractions while moving painful joints through a specific range of motion. It is used to reduce pain and restorative muscle functionality.

• Soft Tissue Mobilization

Myofascial release techniques promote drainage of lymphatic fluid from the affected area resulting in soft tissue mobilization in the lower back, hips, or legs. It decreases muscle tension promoting soft tissue healing. The technique involves the usage of hands or six stainless steel instruments to treat fascial restrictions.

• Gait Training

Gait training involves a detailed analysis of walking techniques and retraining correct gait patterns and movement. This may involve filming the patient walking and analyzing the video to assess the problem areas that need improvement.

Advantages of Physical Therapy

Physical therapy relieves pain from radiating lower back pain and sciatica through manual therapy, exercise programs, and rehabilitative programs. Physical therapy helps in strengthening inflamed muscles, sore joints and facilitates mobilization in soft tissues in the lower back, pelvis, abdomen, buttocks, and thighs.

Physical therapy helps restore pain-free functionality, relieve pain, reduce muscle spasm, restore the functionality of the lumbar spine and the sacroiliac joint, improve mobility of the lower back, promote neurological adaptations to reduce perceived pain, and prevent future flareups. It helps instill confidence and reduces the fear associated with movement by reducing the risk of injury caused due to hampered movement.

Physical therapy may be used in conjunction with other pain-relieving treatments such as over-the-counter or prescription medications.