Sciatica
Sciatica is pain from an irritated sciatic nerve, usually running from the buttock down the back of one leg. It is a symptom, not a diagnosis, so physical therapy works by finding what is irritating the nerve, often a disc in the low back, and treating that. Western Slope Rehab and Performance helps patients with sciatica in Grand Junction, Fruita, Palisade, Orchard Mesa, Appleton, Clifton and the Redlands.
Why the pain travels down your leg
The sciatic nerve is the largest nerve in your body. It starts in the low back, passes behind the hip and runs down the leg. When a nerve root is pinched in the low back, or squeezed further along its path, you can feel it far from the source: pain down my leg, a pinched nerve in the lower back, buttock pain or tingling down the leg.
That is why treating only the spot that hurts often falls short. Your physical therapist tracks the symptoms back to where they start.
What sciatica can feel like
- Shooting pain in the leg
- One-sided buttock pain
- Numbness in the leg
- Tingling or pins and needles
- Leg weakness
- Pain that is worse when sitting
- Burning down the back of the thigh
Common causes we look for
Herniated disc
A disc in the low back presses on a nerve root. This is the most common cause.
Spinal stenosis
The channel the nerves pass through narrows, often with age, and walking or standing can bring on leg symptoms.
Piriformis syndrome
A deep buttock muscle tightens around the nerve. Long sitting tends to bring it on.
Spondylolisthesis
One vertebra slips forward on the one below it and can narrow the space for the nerve.
How we sort out where it is coming from
Movement testing
Repeated bending and standing movements show whether your leg symptoms move closer to or farther from your back. That guides which exercises to use.
Nerve and strength screening
Reflexes, sensation and muscle strength in the leg show how much the nerve is involved.
Hip and buttock exam
Hip mobility and the deep gluteal muscles are checked to tell a back source from a piriformis source. Hip problems have their own page on Hip Pain.
Treatment and what recovery looks like
Your plan may combine directional preference exercises, core stabilization and leg strengthening, Manual Therapy to ease stiffness around the nerve, and Dry Needling for tight buttock and low back muscles. Exercises are progressed through Therapeutic Exercise as your symptoms settle.
Many patients with sciatica improve over weeks with a steady exercise plan, and many do not need surgery. Timelines vary with the cause, and your therapist will tell you what to expect after your evaluation.
Low back pain without leg symptoms is covered on Back Pain. Numbness in both feet that does not come from the spine is a different problem, and your therapist or doctor can help sort it out.
Get medical help right away if...
- Your foot drops or leg weakness is getting worse
- You lose control of your bladder or bowels
- You have numbness in your groin or inner thighs
These can mean serious pressure on the nerves. Go to the emergency room.
Treat the cause, not just the leg
Patients come to us from Grand Junction, Fruita, Palisade, Orchard Mesa, Appleton, Clifton and the Redlands. You can start physical therapy without a referral from a doctor in most cases. Some insurance plans, including Medicare, still need a doctor to sign the plan of care. Call (970) 314-9822 or see Direct Access.
We see patients from Grand Junction and the surrounding Grand Valley: Fruita, Palisade, Orchard Mesa, Appleton, Clifton and the Redlands.