When a bulging disc squeezes on the sciatic nerve, it can cause radiating pain down the back of the leg. People describe this as a burning, aching, tingling, or throbbing sensation. The diagnosis is called lumbar radiculopathy because the source of the problem is the lower back (lumbar) and the transference of pain is down one or the other leg (usually not both). 

When to see a physical therapist for sciatica

If you’ve been living with sciatica, you may have tried a variety of treatments and medications to deal with pain. Under medical supervision, a provider will usually start with a medical exam and some testing which may include:

• MRI
• X-ray
• CT scan
• Electromyography (EMG) or nerve conduction studies

Medications to treat sciatica often include anti-inflammatories and opioids as well as corticosteroid injections. Some patients also benefit from anti-seizure medications and antidepressants because of their side benefits of nerve pain relief.

But what if you’ve tried all of that and it’s still not working? 

You probably need a physical therapist who can help you with short- and long-term pain-relief from sciatica. 

Seeing a physical therapist for sciatica: What to expect

Your physical therapist will do a thorough assessment of your condition which will include exploration of your medical history and any history of trauma that caused the sciatica. You’ll be asked to perform different stretches and leg lifts which can help the therapist identify your range of motion and functionality. 

Your therapist will also assess how you walk (your gait) to see how sciatica nerve pain impacts the way you move. For example, some people might be experiencing so much pain, they compensate by adding more weight to the other leg, further compromising the body.

Your physical therapist will also ask different questions about how sciatica affects your daily life, such as:

• Is it triggered by sitting or lying down?
• Does it worsen as the day goes on or is it about the same?
• Does walking and exercise seem to help, or does it not make any difference?

Once your therapist has a full understanding of your condition, they’ll develop a customized physical therapy program for you. Depending on the severity of your sciatica and the pain you’re experiencing, a PT program may last anywhere from eight to 12 weeks. You’ll usually need to go on-site for therapy at least twice a week, if not three times. Frequency helps the body respond more readily and helps you gain momentum.

Again, every patient is different. Your physical therapist and staff will accommodate your busy life and help make sure you’re getting the most out of your program.

How physical therapists treat sciatica nerve pain

Your physical therapy program is meant to accomplish certain goals over the course of your treatment, including:

• Relieving pain in your lower back, thigh, leg and buttock
• Reducing muscle spasm
• Restoring joint function in the lumbar spine and sacroiliac joint
• Improving lower body mobility
• Preventing pain flair-ups in the future 

To accomplish this, your physical therapist may introduce a wide variety of treatments and techniques to reduce sciatica nerve pain. Some of the most effective treatment options include:

Strengthening exercises – such as bridge holds and use of resistance bands and weight training

Joint mobilization – when a therapist applies joint pressure to produce a therapeutic effect

Dry needling – the use of fine needles to identify, target and release pain through trigger points in the body

Extension and flexion exercises – exercising backward and forward in specific ways to target and reduce radiating pain symptoms

Hot and cold therapies – used alternatingly to help stimulate blood flow to the affected area and reduce spasms, inflammation and pain

These are just some examples of the therapies that may be introduced. Your physical therapist will work with you along the way to identify appropriate treatments to minimize your pain and achieve optimal results.

Also keep in mind that it may take a few weeks to start experiencing relief from sciatica nerve pain. Physical therapy may be harder on some days than others. You may feel like you’re going forward and then experience a set back because of a pain trigger in your daily life. 

Be patient with yourself and with the physical therapy process. Your therapist will also give you a home exercise program to help you stay on track in between visits. It’s important to do your best to apply what you’ve learned at therapy at home as well. You may need to think in terms of lifelong wellness when it comes to sciatica and back pain. For many people, it comes and goes.

Ideally, you’ll want to implement the exercises you’ve been given at physical therapy into your daily life so you can maintain the gains you’ve achieved through your physical therapy program. 

Interested in talking to someone about sciatica nerve pain?

Give us a call at (941) 375-3006 or fill out the form to see if physical therapy is right for you. Same-week appointments are available.

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