18/03/2026
Sciatica is not a condition on its own, but a symptom caused by irritation or compression of the sciatic nerve, the largest nerve in the body. The pain usually radiates from the lower back down into the buttock, leg, and sometimes the foot.
Here are the main causes of sciatica:
1. Spinal causes
• Herniated / slipped disc – the most common cause; the soft inner part of a spinal disc pushes out and compresses the nerve.
• Degenerative disc disease – wear and tear causes discs to thin or collapse, narrowing the spaces where nerves exit.
• Spinal stenosis – narrowing of the spinal canal, putting pressure on the nerve.
• Spondylolisthesis – when one vertebra slips forward over another, pinching the nerve.
• Osteoarthritis and bone spurs – extra bone growth can press on nerves.
2. Muscle and soft tissue causes
• Piriformis syndrome – the piriformis muscle in the buttock spasms or tightens and irritates the sciatic nerve.
• Muscle imbalances or tight hamstrings/glutes – can indirectly irritate or compress the nerve.
3. Injury or trauma
• Falls, car accidents, or sports injuries damaging the spine or pelvis can irritate the sciatic nerve.
4. Other contributing factors
• Tumors or cysts pressing on the nerve (rare).
• Infections that affect the spine or discs (rare).
• Pregnancy – weight and posture changes may compress the nerve.
• Obesity – extra body weight increases pressure on the spine.
• Prolonged sitting / poor posture – can aggravate or worsen nerve compression.
Here’s how a physiotherapy can help with sciatica and related pain using the following therapies:
1. Dry Needling
• Very thin needles are inserted into trigger points (tight knots in muscles).
• This helps release muscle tension, reduce spasms (e.g., piriformis muscle pressing on the sciatic nerve), and improve blood flow.
2. TENS Therapy (Transcutaneous Electrical Nerve Stimulation)
• Small electrical impulses are delivered through pads on the skin.
• This blocks pain signals from reaching the brain, stimulates endorphin release, and reduces nerve-related pain and inflammation.
3. Spinal Manipulation (Adjustments)
•central and unilateral Pa’s + transverse pa’s
SNAGs (Sustained Natural Apophyseal Glides), uses gentle, manual "sliding" pressure on vertebrae to correct joint dysfunction
• This relieves pressure on compressed nerves, restores movement in stiff joints, and improves posture — reducing irritation of the sciatic nerve.
4. Soft Tissue Therapy
• Techniques like stretching, myofascial release, or instrument-assisted therapy target tight or inflamed muscles.
• Helps relax spasms, improve circulation, and decrease nerve irritation.
5. Ischemic Compression
• physio applies steady, focused pressure to a trigger point or tight spot.
• Temporarily reduces blood flow, then increases circulation once released — easing pain, loosening knots, and reducing referral pain down the leg.
6. Massage Gun Therapy (Percussive Therapy)
• A handheld device delivers rapid pulses to muscles.
• Promotes blood flow, decreases muscle tightness, reduces soreness, and enhances recovery.
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