It is not unusual for people to visit my clinic with sciatica, limping in pain and favoring their back or legs.

Physicians often suggest physical therapy and stretching to help relieve the intense pain of sciatica. The ideal outcome is that the pressure on the sciatic nerve – which travels from the lower back down the leg – is relieved through stretching and exercise, mitigating the suffering and eliminating the limping.

How sciatica causes pain

Sciatica is not a medical diagnosis, but rather a symptom that points to an underlying physical problem. Sciatic pain originates in the lower back’s lumbar region and radiates down to the back of the legs.

The sciatic nerve can become the source of pain when it is compressed by tissue, bone or scar tissue. The nerve travels through the lumbar vertebrae, across the buttocks and then branches down the legs to the feet.

Problems that generate this type of sciatic pain include:

• Pelvic misalignment

• Herniated disc

• Stenosis (narrowing of the nerve space)

• Tightening of the hip joint

Pain relief

The sciatic nerve system consists of the largest nerve and individual nerve roots branching out from the spine. Sciatica is considered one of the most painful conditions that involve the lower back and legs. When the large sciatic nerve is irritated in the lumbar vertebrae, closest to the point of origin, the pain is greater.

Different areas of compression along the nerve are often the cause of varying symptoms involving the lumbar area of the back, muscles of the buttocks, the back of the thighs, behind the knees, ankles, feet and toes. Nerve impingement creates numbness, tingling, weakness and deep pain.

Managing symptoms

Sciatica pain can vary, ranging from constant and incapacitating to occasional mild episodes. The pain varies because of the different locations where the sciatic nerve could be compressed or pinched.

Some patients experience pain, tingling and numbness down both legs, while others experience sciatic pain on only one side, down one leg.

Unlike other types of back injury pain problems, physicians recommend that patients keep moving, because they need to maintain their back and leg muscle strength to prevent further compression in the sciatic nerve.

Doctors often recommend that patients meet with a physical therapist to determine a set of therapies most appropriate for specific pain areas. Solutions could include exercise, stretching or proper bending, depending on when and how patients experience pain.

Clinical research studies show that the sooner a patient begins therapy, the better the outcome. Physical therapies should begin within 16 days of the onset of pain.

Kim Gladfelter is owner, physical therapist and Pilates instructor at PhysioFit Physical Therapy and Wellness, 1000 Fremont Ave., Los Altos. For more information, call 887-6046 or visit