Many golfers and tennis players suffer from sciatica pain. This webinar features insights from both a DO and a PT to support patients suffering from sciatica. Our very own Dr. Allen Harris joins the team from FLASH Momentum to discuss the topic.
What is sciatica?
At Beatty Harris Sports Medicine, sciatica is the most common musculo-skeletal disease for which patients seek medical attention. Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. We typically see sciatica as a unilateral leg condition rather than a bilateral leg condition.
Symptoms to Take Note Of
If you see Dr. Harris for low back pain and a potential sciatica diagnosis, he'd ask you a few questions to investigate the source of your pain to determine if it really is sciatica or something more serious. Below are some questions he might ask:
Was there a specific incident that started your pain like lifting a heavy box, gardening, or playing tennis/golf? Or has your pain increased over time? There are different diagnoses and treatments for either situation.
Have you been doing stretches and exercises and your pain hasn't gone away or has gotten worse?
Do you have any numbness or tingling? Radiating pain? Where is the pain traveling? Is it traveling down the side of your leg? Does it stop at your knee? etc.
Have you noticed a loss of strength – trouble walking or increased fatigue when doing exercises or activities?
Do you have any muscle loss or notice that your one thigh is getting smaller than the other? If this happens, see a sports medicine doctor immediately. The earlier we can intervene, the easier it is to treat.
Red Flags To Look Out for with Low Back Pain
There are some symptoms that are considered emergent. If you have any of these symptoms, seek a sports medicine doctor immediately for diagnosis.
Loss of bowel or bladder control.
Sudden or non-purposeful weight loss.
Fevers or night sweats
Most treatments for sciatica pain (and most low back pain) include physical therapy, strength training, and flexibility. core strengthening will be a focus in PT along with lower extremity strengthening and stretching. Restoring motion is also incredibly important.
In addition to physical therapy, there are medications (either over the counter or prescribed by a sports medicine doctor) that can help with the pain and inflammation.
The majority of low back pain doesn't require imaging. A good sports medicine physician can identify where the pain is coming from and develop an appropriate treatment plan. If considered necessary, an ultrasound (available in the Beatty Harris Sports Medicine office) or X-Ray followed by an MRI might be the right course of action.
The X-Ray is a way to rule out any serious problems involving the boney structures. When receiving a patient's X-Ray, Dr. Harris would be looking for things such as pathological fractures or tumors (if there have been complaints about weight loss or night sweats). He'll also be able to recognize any disk height loss, spondylosis, or degenerative changes.
Dr. Harris admits, though, almost everyone who gets an X-Ray for this type of pain will have some degree of degenerative change so that's not necessarily abnormal.
If there are no serious findings on x-ray, Dr. Harris will usually recommend a 4 – 6 week physical therapy treatment plan and over that time, he'd expect to see substantial improvements in pain. If there is no significant improvement in pain, the next step is usually to get an MRI.
An MRI for low back pain is the important next step if PT hasn't helped or if you're having any neurological symptoms such as numbness or tingling going down the leg, loss of muscle, or loss of reflexes in your affected leg.
With an MRI, Dr. Harris would be able to see where nerve impingement occurring and why. Whether it's a slipped disk/ruptured disk in the back or degenerative changes that have escalated so much that it's pinching off some of the nerve roots as they exit the spine.
Dr. Harris typically recommends an MRI if he expects a patient to be a candidate for a back injection or some type of surgical intervention. However, there are many cases where the source of back pain is actually stemming from the hip either due to arthritis or some kind of greater trochanteric bursitis with chronic tendinopathy on the outside of the hip.
Do you have any other questions about sciatica?
Contact Dr. Harris to make an appointment!
BEATTY HARRIS SPORTS MEDICINE | NEWTOWN SQUARE
3409 West Chester Pike
Newtown Square, PA 19073
BEATTY HARRIS SPORTS MEDICINE | CHERRY HILL
496 Kings Hwy N
Cherry Hill, NJ 08034
We are located inside 3DPT.