Injury clinic: Best treatment for sciatica

How to cope as a runner

How to beat sciatica

What is sciatica and how is it caused?

Sciatica means pain caused by irritation or compression of the sciatic nerve. The sciatic nerve is the longest nerve in the body and runs from the rear of the pelvis, through the buttocks and down both legs. Sciatica refers to pain in the lower back, rear of the leg and sometimes the foot. Physiotherapist Tim Allardyce, Clinical Director of Surrey Physio (surreyphysio.co.uk), says: “The two major causes of sciatica are a disc bulge – also known as a slipped disc – or a disc prolapse, where the disc that sits between the vertebrae in the lower back bulges or slips backwards, and tends to compress the sciatic nerve. Pain runs down the buttock, the back of the leg and the heel.”

Sciatic pain can be sharp, burning or a numb feeling. It can be mild or severe. “Sciatic pain can affect the whole leg in a number of ways from the classic pain through to weakness and tightness which is often confused with local muscle symptom,” says physio Mark Buckingham from Witty Pask & Buckingham (wpbphysio.co.uk).

There doesn’t appear to be a direct link between running and a slipped disc, but the jarring effect of running can make the pain worse. “The most common causes of sciatica are sitting a lot, sedentary lifestyles and forward bending,” says Allardyce. “Running often aggravates it.”

How do I treat it?

Switch to low-impact exercise like cycling, swimming or using the cross-trainer. Walking and stretching may help and physios often recommend Pilates to strengthen your core. “The stronger the back and core, the more load you can take through your spine,” explains Tim. “But once you’ve slipped a disc badly, the problem may not go away. You tend to have a weakness in the back.”

Piriformis syndrome

Piriformis syndrome can cause similar nerve pain, but is not caused by a disc bulge. “The piriformis is a small pearshaped muscle in your butt,” says Allardyce. “In some people, the sciatic nerve goes right through the piriformis and if the muscle gets tight, the nerve can be compressed. A physio would do deep tissue massage into the buttock and it tends to respond better and doesn’t cause further complications. It takes four to six weeks to heal.”


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