How Physical Therapy Can Treat Sciatica Caused by Low Back Pain

Back pain is the second most common symptom-related reason for physical therapy in the United States. Up to 84% of adults have low back pain at some time in their lives, with sciatica affecting up to 40% of those with low back pain. The long-term outcome of low back pain is generally favorable, but persistent symptoms affect millions of individuals. Sciatica accounts for approximately 5% of people with back pain who go on disability, and for up to 75% of the costs associated with low back pain. Noninvasive intervention, such as physical therapy is an important tool that can play a significant role in reducing healthcare costs.

What is Sciatica?

The term sciatica describes the symptoms of leg pain-and possibly tingling, numbness or weakness-that originate in the lower back and travel through the buttock and down the large sciatic nerve in the back of the leg.

Sciatica is not a medical diagnosis-it is a symptom of an underlying medical condition, such as a lumbar herniated disc, degenerative disc disease, or spinal stenosis. Sciatica is often characterized by one or a combination of the following symptoms:

  • Constant pain in only one side of the buttock or leg (rarely can occur in both legs)
  • Pain that is worse when sitting
  • Leg pain that is often described as burning, tingling or searing (vs. a dull ache)
  • Weakness, numbness or difficulty moving the leg or foot
  • A sharp pain that may make it difficult to stand up or to walk

How to treat Sciatica Symptoms caused by Low Back Pain

  1. Ultrasound: Ultrasound is often recommended before stretching of the piriformis muscle. Ultrasound is a form of deep heating in which sound waves are applied to the skin and penetrate into the soft tissues. Ultrasound is especially useful in relieving acute episodes of pain and may enhance tissue healing.
  2. TENS: TENS, or transcutaneous electrical nerve stimulation, is a back treatment modality that uses low voltage electric current to relieve pain. TENS is effective for treatment because it causes the local release of neurotransmitters such as serotonin to block the pain signals in the brain.
  3. Iontophoresis: Iontophoresis provides a means of administering medication transdermally using a low, direct electrical current to drive it to the involved tissues of the low back. Frequently, it is used to administer anti-inflammatory medications to local tissues. A secondary benefit for iontophoresis is the electrical current itself that can immediately reduce symptoms by blocking pain receptors.
  4. Traction table: Lumbar traction using a traction table operates under the theory that separation of the lumbar vertebrae will decrease impingement of the spinal nerves as well as decrease pressure between the discs.
  5. Low Level Laser Therapy: Low Level Laser Therapy helps relieve muscle tension, spasms, inflammation, fluid retention, aches, stiffness, and pain. Other benefits of LLLT include improved circulation (blood and lymph), general flexibility, range of motion, and increased tissue elasticity (ex: scar tissue). In a study published in The Australian Journal of Physiotherapy, results showed that Low Level Laser Therapy combined with exercise drastically reduced pain and increased lumbar range of motion in patients complaining of severe low back pain.

Low back pain is an expensive drain on healthcare and individuals. When left untreated low back pain can go on to cause further problems, such as sciatica, thus increasing its detrimental effect. Physical therapy is a time and cost-effective way to combat the effects of sciatica and low back pain, helping patients get back to the task of living their lives pain-free.