Course Description:

Sciatica is a collective term that describes symptoms of sciatic neuropathy, such as radicular or referred pain and paresthesia in the affected lower extremity. Intervertebral disc herniation is the most common cause. The dermatomal distribution pattern of sciatica that results from disc herniation is usually specific for the spinal root(s) of the sciatic nerve that might be impinged/irritated. Tension on the sciatic nerve in hip flexion with the knee extended, such as in the straight-leg raise (SLR) test, often reproduces the patient’s complaints. Additionally patients might display reduced trunk mobility and flexibility of the involved lower extremity. There is consensus that treatment of acute sciatica should be conservative in the first 6-8 weeks, with patients advised to continue their regular activities of daily living (ADLs) within pain tolerance. Bed rest should be discouraged. Therapeutic exercise might be needed to address impairments in strength and trunk stability. Functional training might be needed to correct deficits in posture, gait, and general mobility, as well as to address improper body mechanics/technique during ADLs that provoke or aggravate pain. Evidence is lacking to support the use of electrotherapeutic modalities to alter the course of sciatica or recovery.