Physical Therapy for Sciatica

Physical therapy for sciatica is a good way to find well-informed guidance during the recovery process. Dealing with sciatica symptoms can be frustrating, especially with so many self-treatment options online. See our guide for help on finding the right physical therapy program for your needs.

How Can Physical Therapy Help?

Seeing a physical therapist can yield a lot of potential benefits for dealing with sciatica and low back pain. These include:

• Developing a personalized home exercise program to address symptoms and functional deficits.

For home program ideas, see exercises for sciatica.

• An in-depth lifestyle assessment to promote long term recovery
• Potential quicker recovery and less severe symptoms than self-care alone
• Reduced anxiety thanks to proper education and awareness surrounding sciatica
• Addressing any other complicating factors that may be exacerbating your symptoms i.e. posture, poor gait, and other daily activities

Goals of Physical Therapy

Listed below are the typical goals that you will work toward with your physical therapist.

• Address deficits related to strength and flexibility in the back and legs 
• Restoring coordination and muscle balance for daily activities
• Gaining a full understanding of your injury
• Discharge with a home program to continue for relief as needed
• Implementing sciatica pain relief via modalities, massage therapy, education, and home self-care

Techniques

There are many possible treatment options you might initiate at a clinic visit with a physical therapist. What is best for you depends on your specific needs and preferences. They may include one or more of the following options, the main focus is always on restoring function.

• Functional Retraining

  Low back and leg pain caused by sciatica can lead to maladaptive movement patterns. When pain is involved, it may leave you feeling crooked, stiff, or even with a limp when you’re walking.  These issues can exacerbate your symptoms and perpetuate imbalances throughout the spine and core. A physical therapist can help identify faulty movement patterns and help you regain coordination, muscle strength, and control with a treatment plan.

• Gait Training

  Gait, or walking, is essential for independence and normal daily function. Sciatica pain can quickly alter gait patterns and make walking difficult. As with other activities, you may be making symptoms worse due to your gait or your gait may have initiated your sciatic symptoms.  Addressing the root of your gait issues with analysis, education, and proper training and feedback will get you back on track.

• Joint Mobilization

  The spine requires an intricate and balanced amount of flexibility and stability for normal, pain-free function. When any joint in the spine becomes immobile, it can lead to full spine dysfunction and put additional strain on the joints surrounding the stiff area. Joint mobilization is a specialized technique for restoring movement to these affected areas, ranging from gentle movement to high force joint manipulation.

  Try practicing self-mobilization at home with foam rolling.

• Manual Therapy

  Manual therapy encompasses any physical therapy technique that addresses stiffness, muscle spasms and impaired connective tissue. Patients typically think of it as a type of specialized, focused massage. Techniques include joint mobilization (as described above), deep tissue, soft tissue, fascia release, trigger point release, muscle energy techniques and more. The goal is to restore balance to affected areas, that can then be reinforced by other treatment options.

  Check our full resource of massage for sciatica pain.

• Range of Motion

  Spine, hip, and pelvic range of motion are important for pain-free unrestricted movement with daily activities. A therapist can provide active assisted, passive, or verbally guided range of motion exercises to restore normal function where it is needed throughout the body. For home, you can expect to be given stretches to improve overall flexibility where it’s needed.

  Yoga for Sciatica Pain

• Dry Needling

  This is a specialized technique for addressing trigger points in painful, tight, affected muscles. Only to be done by a certified physical therapist. Check your state's regulations as it isn’t available in all states. The needle looks similar to a thin acupuncture needle and is inserted in the center of an affected muscle area to promote muscle release via.  While some people find it hard to tolerate it, others find it to be an essential part of their recovery process.

• Modalities

  There are many pain-relieving modalities that a physical therapist can provide in the clinic or recommend for home. These include hydrotherapy (a deep heating moist heat pack), ice, ultrasound, a TENs unit, light therapy, and diathermy. All these options are meant to promote relaxation and circulation for pain relief.

Can Physical Therapy Make Sciatica Worse?

There is always a risk for exacerbating nerve pain symptoms as you start your recovery journey.  However, with the guidance of a physical therapist, you will feel in better control of your symptoms. Plus, you will better understand how to modify your daily activities and program until you are ready to tolerate more. What will work best for you depends on underlying problems such as spinal stenosis, a herniated disc, and other lumbar spine issues.

Taking the Right Precautions with Physical Therapy for Sciatica

Professional guidance can have its benefits but the most important thing is to keep up with what your therapist recommends at home consistently. If you experience an exacerbation of symptoms, particularly neurological changes like increased numbness, tingling, burning, weakness, or changes in bowel or bladder control, talk to your therapist immediately. If your medical insurance requires it, talk to your doctor first for a prescription.

Sources:

https://www.healthline.com/health/dry-needling-vs-acupuncture

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