Sciatica

Sciatica

Sciatica describes the symptoms of pain (mostly) and sometimes tingling and numbness that runs from the Lumbar Spine into the buttock and down the back of the leg and sometimes foot.

What is the Cause?

The majority of sciatic symptoms come from back disorders between L4-S1 that put pressure on or cause irritation to a lumbar nerve root.

The symptoms can arise from an underlying Herniated Disc or Spinal Stenosis (which can compress the nerve root), or a degenerative disc or facet joint, which will release inflammatory proteins and irritate the nerve.

Signs & Symptoms

There can be any combination of the following:

  • Buttock, leg and/or foot symptoms
  • Burning, sharp, searing pain as opposed to achy or throbbing
  • Tingling / pins and needles
  • Weakness of leg or foot
  • Symptoms are usually only in one leg
  • Symptoms that are intermittent (can get better or worse, rather than staying constant)
  • Can be aggravated by sitting, walking, standing, twisting or bending

What Can We Do About It?

Physiotherapy will aim to identify the cause of your sciatic pain and treat with a combination of hand on therapy and specific sciatica relieving exercises

The Standing Desk

The Standing Desk

The standing desk seems to the latest new craze to avoid work related back problems. But do you know how to get the most out of your standing desk?

Yes the standing desk is a great way to avoid the sustained flexion we experience when sitting, but standing in one position for long periods can also have negative effects on our posture and musculoskeletal system. The best option is to alternate between sitting and standing positions throughout the day. One study found that a ratio of 2:1 sitting versus standing is optimal for body posture and for best productivity results.

It is key to remember the correct set up for both a standing and a sitting desk. Whether it is sitting or standing the correct desk height and computer screen position is crucial.

As a guide, the desk should be positioned so the elbows are at approximately a 90 degree angle. It has been found that the screens optimal position is 20-10 inches from the face, with the top of the screen at eye level. So as you don’t tilt your head forwards or backwards, the screen itself should have a 10-20 degree tilt back

When either sitting or standing, regular breaks are required. The spine loves movement! Staying in any one position for long periods will cause the spine to become stiff and the surrounding muscles to either shorten or lengthen away from their optimal position. Some people will naturally change positions regularly. For those who don’t, an app on your smart phone or installing reminder software on your computer may be a better option.

So remember

  • Vary sitting and standing throughout the day
  • Correct desk set up is crucial
  • Regular breaks are necessary to decrease occurrence of poor posture and musculoskeletal abnormalities

Degenerative Disc Disease

Degenerative Disc Disease

Degenerative disc disease refers to the process of degeneration of an intervertebral disc. Your intervertebral discs are the fluid filled sacks, which lie in between each vertebrae and act as the shock absorbers for your spine. They are made up of two parts: Inner nucleus pulposes and outer annulus fibrosis.The annulus fibrosis is made up of dense fibrocartilage rings and encases the nucleus. The outer ring of the annulus is innervated, meaning there is a nerve supply and can be painful when damaged. The nucleus is the inner part of the disc, which is jelly like in consistence. It changes shape as it adapts to the different loads placed on the disc. A healthy disc is fluid filled. Breakdown of a disc begins when it becomes dehydrated or loses part of its fluid content. This can initiate a cascade of events, which leads to eventual breakdown, and degeneration of the spinal complex.

Disc degeneration can lead to: 

Disc degeneration is a normal part of the ageing process. It is important to note that you can have disc breakdown with the absence of pain. The good news is there is lots you can do yourself to rehydrate your discs and slow the degenerative process down. 

What is the Cause?

Disc degeneration is a normal part of the ageing process however there are certain things that can accelerate the degenerative process.

Risk factors include:

  • Sedentary lifestyle
  • Overweight
  • Poor core stability
  • Repetitive heavy manual labor 

Signs and Symptoms

  • Persistent pain at the bottom of the spine
  • Pain when sitting
  • Pain going from sitting to standing 

What Can We Do About It?

Your physiotherapist will first identify the abnormalities in movement of your spine and will then determine the cause of this.

Core stability training will form a large part of your rehabilitation and prevention of further episodes of back pain.

Movement is the key to rehydrating discs and encouraging repair. Your physiotherapist will provide you with an individualised exercise program to help enable the healing process.