Articles Search Engine

Overview

Acute and chronic back pain is common in athletic and recreational athletes. While many back injuries in athletes can be attributed to muscle strain, some athletes can suffer from a painful condition involving inflammation of the sciatic nerve.

What are the classifications of sciatic pain?

The signs and symptoms of sciatic pain may include radiating pain (pain that radiates down the back of the pelvis and leg following the nerve pathway) with the radiating pain possibly worse than the lower back pain (depending on the cause). The pain may increase when the patient coughs, sneezes, strains, sits or leans forward.

The athlete may also experience numbness and tingling down the leg with associated muscle weakness. To attempt to minimize the discomfort, the athlete may walk with a noticeable limp and with a side tilt.

According to Anderson, M.K., Halls, S., & Martin, M. (2005), there are four classifications of sciatic pain including the following:

• Sciatic pain only: no sensory or muscle weakness
• Sciatic pain with soft signs: some sensory changes, mild or no reflex change, normal muscle strength, normal bowel and bladder function
• Sciatic pain with hard signs: sensory and reflex changes, and muscle weakness caused by repeated, chronic, or acute condition; normal bowel and bladder function
• Sciatic pain with severe signs: sensory and reflex changes, muscle weakness, and altered bladder function

What causes sciatic pain?

Sciatic pain may be caused by a number of structural problems and may be caused by either an acute (one time injury) or chronic (over time) mechanism of injury. A diagnosis of chronic sciatica may be indicated if there is no clinical improvement of symptoms after 2-4 weeks even with treatment (Bahr, R. & Maehlum, S., 2004).

Possible causes of sciatic pain may include the following:

• Herniated disc (protrusion of nucleus pulposus past annulus fibrosis impinging on sciatic nerve)
• Annular tear
• Spinal stenosis (narrowing of intervertebral foramen)
• Facet joint arthropathy
• Compression of sciatic nerve from piriformis muscle

Although there are a number of possible causes, the most common cause of sciatic inflammation is from herniation of lumbar discs at L4-L5 and L5-S1 (Anderson, M.K., Hall, S., & Martin, M., 2005).

Prevention

What can I do to prevent sciatic pain?

Preventing sciatic pain associated with intervertebral disc injury should begin with focusing on the causes of disc injury and taking steps to prevent those types of injury. Because most disc injuries are caused by a combination of rotation of the spine while the spine is in flexion, prevention needs to focus on correct back mechanics and avoidance of motions that may place the spine at risk for injury.

As stated above, teaching an athlete how to find and maintain a neutral spine is one key to preventing disc injuries. If an athlete can maintain his/her spine in a neutral position during all activities, then the spine will be at a lower risk for injury.

Maintaining core strength is integral in maintaining a healthy back and preventing a number of sports injuries to the back. Core stabilization exercises can be performed by the athlete on their own. Two great examples of core strength exercises are the Prone Bridge and the Side Bridge.

What is the treatment for sciatic pain?

Initial treatment for mild sciatic pain is to reduce the load on the spine by avoiding activities that cause pain including impact from compression (jumping/landing) forces, lifting, bending, twisting, prolonged sitting and standing (Anderson, M.K., Hall, S., & Martin, M., 2005).

Last, rather than twisting the spine to turn, the athlete should keep the object at his/her midline and turn his/her feet to change directions. Following these simple rules can significantly reduce the risk of soft tissue injuries to the back.

As the symptoms resolve, the athlete can focus on spine and hamstring flexibility, and core strength and stabilization exercises of the spine during daily activities and sports. Athletes will need to focus on strengthening the muscles surrounding the core of the body including the abdominals, obliques, back extensors, and gluteal muscle groups.

To see instructional recovery videos on hamstring flexibility, core strength, and stabilization exercises of the spine please click the following link.