Ugh... not THIS again...

Have you dealt with sciatica before?

If so, then you probably know that the pain can be so bad, sometimes to the point that you're bedridden!  It can keep you from working out, playing with your kids, lifting weights, running, and any other activity you love to do. This is an issue I have treated hundreds of times with great success, ranging from 20 year old active athletes to 90 year old grandmas.  But what exactly is it??

What is Sciatica?

Sciatica refers to irritation to nerve roots that branch out of the spinal cord, which run from your spine to the hip, and down the back of your leg to the foot.   It is a blanket term that has come to encompass any pain down the back of the leg, so symptoms can be wildly variable.

The most common symptoms are pain, burning, tightness, numbness and tingling, and in very severe cases, loss of muscle function.  But understanding that sciatica is an irritation to the nerve is the first step to formulating an effective treatment plan.  Luckily it is a very treatable condition!

If the nerve is irritated, shouldn't our goal for treatment be to reduce the irritation of the nerve? It seems like a simple concept-but not every therapist or doctor understands how to identify and treat it in this way.  When we can get irritation off the nerve-then we can make sure everything else we are doing is more effective, which helps you make a full recovery!

If you want to know 3 things you SHOULD and SHOULD NOT DO when dealing with sciatica- here is another super helpful article we wrote!

Read it here!

Rehabbing from a bout of sciatica can be super quick and simple or it can be a long and difficult process, I have seen it go both ways.  

Symptoms can also start very slowly and gradually over many months or years, or they can start in an instant. 

And the severity of symptoms can range from the most mild tightness or discomfort all the way to searing, burning pain and in very severe cases, loss of muscle function. it is good to know that nearly all cases of sciatica are not medical emergencies or anything that warrants immediate medical attention, but if you have any of these symptoms you NEED to get to the doctor right away, as surgery may be necessary to restore nerve function.

Those symptoms would be saddle anesthesia (numbness around your genitals, buttocks, groin, inner thighs), significant weakness in the muscles of 1 or both legs, loss of control of bowel and/or bladder function, and sudden onset of intense pain that won't go away.

Centralization vs Peripheralization

One of the most basic ways of identifying if our treatments for sciatica are working relies on the concepts of centralization and peripheralization.  These are fancy terms to describe the symptoms moving closer to their source (centralization) or the symptoms moving further away from their source (peripheralization).  In this case, the source of symptoms is the irritation at the nerve root.

A simple way to think about it is when there is more irritation to the nerve we will see the pain, numbness, tightness be more intense and go further down the leg, and be more present overall, i.e peripheralization.  If there is less irritation to the nerve then the symptoms will be lessened and further up the leg towards the source/irritation of the nerve, or centralization.

Centralization➡️ symptoms move closer to the source, this is what we want to happen!

Peripheralization➡️ move further away from the source, what we DON'T want

Easy... right??

The most effective treatments I have ever used rely heavily on the centralization and peripheralization principles described above.  If we can use your bodies natural movements and positions to reduce the pressure on the nerve, then we can help the pain and disability go away much quicker and get you back to the activities you love!

Applying the principles of centralization and peripheralization into your rehab and daily life will be the key to getting a full and fast recovery, and it's much easier than you think!

Check out this article where we break down EXACTLY how you can use these principles in your rehab

You can Read it Here!

If you're in Columbus Ohio area and dealing with sciatica now and want help before it gets worse, schedule a free phone call with a doctor of physical therapy so we can understand more about you and your goals for rehab!