How to Relieve Your Sciatica Pain with Physical Therapy

Are you experiencing the following symptoms?

• Burning or “electric” pain that radiates from your lower back down through your leg
• Numbness, tingling, or a pins and needles sensation in your back or leg
• A sense of weakness or heaviness in your leg

If so, you may have developed sciatica, which isn’t so much a condition in and of itself as it is a sign of something else, such as a herniated disc or issues with your spine. It develops when the sciatic nerve–a major nerve that runs from your lower back all the way down to your feet–becomes pinched or irritated in some way.

Sciatica is a somewhat misunderstood term. Some people use it to describe any pain or discomfort in the lower half of your body. But true sciatica is a neuropathy that affects the sciatic nerve, and to address it, you need to resolve the underlying source of irritation to the sciatic nerve.

Fortunately, the physical therapists at Harter Physical Therapy can help you do exactly that! Today, we want to give you a glimpse of the process we use when addressing sciatica and sciatic pain.

Confirmation, Treatment, Prevention! A Tried-and-Trusted Approach.

Step 1: Confirm Sciatica and Uncover the Cause

When you visit us for your first appointment, we’ll begin by confirming that the discomfort in your lower extremity actually involves the sciatic nerve at all. Other conditions can cause sciatica-like symptoms, such as spinal osteoarthritis or piriformis syndrome.

If we confirm that your sciatic nerve is impaired, our next step is figuring out why. By far, the most common cause of sciatica is a herniated disc, which occurs when an intervertebral disc bulges and presses against the sciatic nerve. Less commonly, spinal stenosis (a narrowing of the spinal canal) can irritate the sciatic nerve, as can damage from osteoarthritis.

Step 2: Develop a Treatment Plan

Once we know why you’ve developed sciatica, we’ll work to develop a treatment plan to address that underlying cause. Fortunately, physical therapy is the preferred method for treating most of the common causes of sciatic pain.

If your sciatica results from a herniated disc, we’ll help you reduce your pain and facilitate your recovery. Herniated discs will generally resolve within 2-8 weeks, and regular physical therapy can help speed up that process. You can expect the following:

• A drug-free pain management plan utilizing manual therapy, movement modifications, and pain-relieving modalities
• Targeted mobility exercises to free up restrictions in your spine
• Postural corrections to remove pressure from the herniated disc
• Strengthening exercises, particularly in your core, to help stabilize and support the spine
• A return-to-activity schedule to ensure you don’t reinjure yourself

If your sciatica results from spinal stenosis or arthritis, we’ll focus on helping to relieve the pressure from your sciatic nerve. Treatment will generally resemble what we do for herniated discs, including pain management, mobility work, and strengthening exercises, adapting them as needed.

Step 3: Prevent Future Bouts of Sciatica

Once we’ve helped resolve your sciatica, we also want to help prevent it from occurring again. We’ll provide you with the guidance you need to stay pain-free. Here are a few sciatica prevention tips to get you started:

• Use proper lifting techniques. We’ll show you what you need to know.
• Improve your posture, which means keeping your spine in alignment. Our PTs can show you how!
• Avoid prolonged postures, especially prolonged sitting. If you have a desk job, get up and move around every 30 minutes or so. If you have a job that requires you to stand in one position for an extended period, take breaks and switch up how you’re standing (such as shifting your weight back and forth).
• Get moving! A regular exercise routine will help keep your back and core muscles strong. Our physical therapists can suggest specific exercises and workout options to ensure you stay active even after finishing physical therapy.

Pilates: A Great Way to Strengthen Your Core

At Harter Physical Therapy, we frequently include “core strengthening” as part of our therapeutic exercise plans, and for good reason: a strong core can help reduce back pain, improve your balance and posture, and ensure your entire body moves effectively.

While there are multiple ways to improve core strength, one that we want to highlight today is Pilates. This unique approach to exercise was first developed during World War II and then rose to prominence among New York City dancers in the 1950s. It’s now a staple in fitness centers throughout the world.

Five Reasons Why We Love Pilates So Much

1. It’s a “mind-body” exercise that incorporates stretching and breathing exercises alongside strengthening exercises, adding a stress-relieving quality to your workout.
2. It targets your deep core muscles–the muscles most responsible for stabilizing your spine, reducing back pain, and improving your posture.
3. It helps improve your body awareness (proprioception), a key factor in preventing falls and injuries (alongside core strength).
4. With a little instruction and the occasional modification, Pilates is appropriate for almost everyone, including pregnant women, people working through rehab, and those just starting to get active.
5. It’s low-impact yet challenging. Most exercises work by asking you to move your limbs as you hold your body in a specific shape, helping all the parts of your body work together.

Sources: https://onlinelibrary.wiley.com/doi/abs/10.1002/msc.1563, https://pubmed.ncbi.nlm.nih.gov/29332746/ 

Honey Garlic Chicken Thighs

Crispy, sticky and full of flavor – these honey garlic thighs are weeknight magic, and somehow ridiculously easy. No marinade, no deep-frying, no stress.

CHICKEN

• 6 boneless chicken thighs, skin on or off, can be substituted with chicken breast
• ½ tsp sea salt flakes
• ½ tsp freshly cracked black pepper
• 1 tbsp olive oil

HONEY GARLIC SAUCE

• 3 tbsp tamari or all-purpose soy sauce
• 3 tbsp honey
• 1 tbsp brown sugar
• 1 tbsp freshly minced garlic
• 1 tbsp rice vinegar, or white vinegar
• 1 tsp sesame oil
• 1 tsp cornflour (cornstarch)
• 2 tbsp water

TO SERVE

• Steamed rice
• Steamed Chinese broccoli, or any Asian greens
• Finely sliced spring onion, scallion
• Chili oil

Instructions:

• Prepare the chicken – Pat the chicken thighs dry with a paper towel. Season both sides with salt and pepper.
• Heat the oil in a large, deep pan over medium–high heat.
• Cook the chicken – Add the chicken thighs, skin- or smooth-side down, and cook for 4–5 minutes or until the skin is golden and crisp. If using skin-on chicken, press down slightly when cooking skin-down, using your spatula for maximum crispness. Flip and cook for a further 4–5 minutes or until cooked through. Set aside on a plate. Spoon out any excess fat if preferred, leaving at least 2 tablespoons (for extra flavour).
• Prepare the honey garlic sauce – Combine all the sauce ingredients together in a small bowl. Whisk to combine.
• Combine the chicken and sauce – Reduce the heat to medium. Pour the honey garlic sauce into the pan. Let it bubble and simmer for 2–3 minutes, or until thickened and glossy. Return the chicken to the pan, turning to coat in the sauce.
• Serve – Slice the chicken into strips, if desired, and serve over rice with Chinese broccoli or Asian greens on the side. Spoon over any extra sauce and top with spring onion and chilli oil, if desired.