How does sciatica occur?

Sciatica is an inflammation of the sciatic nerve (the longest nerve in the human body) that occurs as a result of compression of the nerve itself. Sciatica pain usually spreads from the lumbar spine to the gluteal musculature, along the back of the thigh and lower leg, and towards the foot. Also very common is tingling in the legs. 

Sciatica can occur for several reasons and some of the most common are:

  • disc protrusion (disc herniation)
  • bone irregularities (osteophytes, spondylolisthesis)
  • narrowing of the spinal canal (spinal stenosis)
  • nerve compression with hypertonic muscle (piriformis syndrome “ "false sciatica")

Symptoms and diagnosis of sciatica


  • moderate to severe lumbar pain
  • pain in the gluteal area and along the affected leg
  • pain that gets worse with movement
  • tingling in the legs
  • weakness in the legs
  • tingling in the feet and toes
  • inability to control urine and stool



  • medical history - to determine whether there is an old injury or deficit in the lumbar spine area 
  • X-ray - is used to examine potential vertebral fractures, tumors, and bone irregularities
  • MRI or CT (main diagnostics) - are used for the examination of soft tissues, that is, to check for the existence of nerve compression, disc herniation, or any other degenerative changes
  • EMNG - a diagnostic procedure in which the conduction of the sciatic nerve is tested
  • Special Orthopedic tests - are a series of tests that can determine the existence of sciatica symptomatology
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Physical therapy and rehabilitation

Goals of physical therapy in sciatica:

  • reduce / eliminate pain in the spine and along the legs
  • reduce / eliminate tingling in the legs
  • reduce / eliminate tingling in the feet and toes 
  • release of the lumbar muscles
  • increase the mobility of the lumbar spine 
  • increase stability and strength of the body muscles
Types of therapy and their action: 
  • dry needling - serves to release the lumbar muscles, increase the mobility of the lumbar spine, reduce pain and stimulate tissue regeneration
  • chiropractic - acts in such a way that it instantly increases mobility in the lumbar spine area and allows the patient to freely perform rehabilitation exercises 
  • mobility exercises - increase flexibility and mobility in the lumbar spine and musculature
  • strength exercises - restore strength and normal core function 

Rehabilitation of the spine

Frequently asked questions about sciatica:

One of the most common causes of sciatica is discus hernia in which doctors often recommend surgery. 

According to new research and knowledge, surgery in most cases is not necessary and the spine is operated only in 2 situations: when the patient is completely immobile and when he is unable to control urine and stool.

Lumboishialgia (sciatica) is in most cases a chronic condition that bothers patients for many years. 

In our office we have solved long-term sciatica to patients who have had it for over 10 years!

The vast majority of patients who are persistent enough with therapies and exercises (emphasis on exercise) manage to get rid of symptoms in the long run and live without pain and other deficits related to sciatica.

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