Sciatica is defined as a pathology that affects the sciatic nerve and produces abnormal sensations in the territories that this nerve controls, altering its function and the structures innervated by this nerve. This nerve has branches that originate at the L4 level and extend to S2; it is responsible for innervating the entire gluteal area, the back of the thigh and the leg and part of the foot.
The abnormal sensations caused by sciatica are usually tingling, burning, electrical sensations or burning cold. These symptoms are usually felt along the sciatic nerve, from its exit at the buttock to its arrival at the ankle, and can occur along the entire length of the nerve or only along part of it. This nerve is the thickest and longest in the body, which is why when it is affected it is usually very annoying and disabling, preventing us from carrying out daily activities.
This fear of suffering pain while carrying out activities produces a weakening of the muscles innervated by the sciatic nerve, causing more and more pain, as when an activity or movement is carried out, this demand is demanding for the structures involved. This is why physiotherapy advocates an active approach, where the patient is helped to regain lost movement and strength, and is helped to eliminate the fear and frailty caused by pain and other symptoms.
This is why a therapeutic exercise programme is such a powerful weapon, as it will help to improve range of motion, muscle strength and endurance and reduce pain. It should not be forgotten that this should be accompanied by the use of other techniques such as manual therapy, spinal adjustments, dry needling, shock waves or neuromodulation. Whatever the cause of the sciatica (hernia, pyramidal syndrome, subgluteal syndrome, etc.), it can be solved if it is properly assessed and a correct treatment plan is established.