Back Pain vs. Sciatica: Exploring the Distinction

Frank’s Story: A True Case of Sciatica

Frank visited us because his pain was unbearable. He was experiencing it throughout the lower half of his body: in his lower back, through his buttocks, and all the way down to his foot. But it wasn’t just pain. Frank also experienced numbness and tingling throughout his leg, which only alarmed him further.

After learning Frank’s symptoms, we suspected sciatica–true sciatica. Why? A couple of reasons:

• The numbness and tingling indicated a nerve issue
• The symptoms follow along the path of the sciatic nerve, from which the condition takes its name

The next step was determining why. Sciatica isn’t a condition in and of itself but rather a sign that something is impacting the sciatic nerve. After a comprehensive evaluation, including several movement screens, we determined Frank’s sciatica stemmed from a herniated disc in his lower back.

Herniated discs occur when one of the intervertebral discs in the spine bulges or, in rare cases, ruptures. If it irritates the sciatic nerve (the root of which is located in the lower back), it will cause sciatica. In fact, most people with sciatica develop it due to a herniated disc.

Now that we knew the source of Frank’s pain, we were able to create a custom treatment program to strengthen his back and core, helping to relieve pressure on his sciatic nerve as his herniated disc healed.

Laura’s Story: No Sciatica Detected

Laura visited us after her doctor told her she had developed sciatica. She was dealing with intense lower back pain that severely restricted the mobility in her back, making it difficult for her to walk. Sometimes, the pain spread down into her buttocks, too, although it never made it to her legs.

For this reason, we knew it was unlikely Laura had sciatica. Because sciatica affects the sciatic nerve, it always causes radiating pain throughout the lower extremities. She also wasn’t experiencing any signs of a nerve disorder.

However, there was no doubt that Laura was in pain and needed relief! We conducted an in-depth assessment to find out what might be going on. When we took Laura’s health history, we learned that the pain started after she rearranged some heavy furniture in her house. Some additional movement screens confirmed what we suspected: Laura had strained her back muscles.

A strain occurs when the tissue fibers in your muscles or tendons tear. Sometimes, those tears are microscopic but painful nonetheless. Laura’s injury was not only painful but also impacted her movement and posture.

Fortunately, a mild to moderate muscle strain can usually resolve with physical therapy. We developed a customized treatment plan to help her manage pain and improve her range of motion. As she improved, we began incorporating strengthening exercises.

Understanding the “Comprehensive Assessment”

If you’ve been reading our newsletter for a while, you’ve probably seen us mention that we perform “comprehensive assessments” as the first step to treatment. These assessments are a crucial part of our process, as they allow us to better understand your symptoms, identify an underlying cause, and simply learn more about you.

But what exactly happens during these first-session evaluations? What can you expect? Today, we want to provide an in-depth overview so you can feel confident when you visit us for the first time!

The Basics

• Initial evaluations usually take between 30-60 minutes.
• Wear comfortable, loose-fitting clothes like those you’d wear to work out.
• Be sure to arrive 15 minutes early so we can take care of any necessary paperwork.

Part 1: Health History and Symptom Evaluation

We’ll start by taking a complete health history. This includes any diagnoses you have and a discussion about what brought you into the clinic in the first place. The more information you can share about your symptoms and/or condition, the better.

For example, if you’re experiencing pain, make sure to tell us…

• Where the pain is located and whether or not it moves around
• The exact sensations of the pain (aching, burning, etc.)
• Whether it’s accompanied by additional symptoms, like mobility restriction or swelling

If you suffered an injury, we’ll also ask for detailed information about what exactly you were doing and what the injury felt like. 

Part 2: Time to Get Moving

Not only will we ask you to discuss your symptoms, but we’ll also ask you to perform simple screens so we can measure any impairments that might be affecting your condition. What exactly we look for will vary based on your health history, but we often evaluate the following:

• Range of motion 
• Strength 
• Balance
• Posture
• Walking pattern
• Specific functional movements like bending, squatting, kneeling, and reaching. 

Don’t feel intimidated by these screens. We aren’t grading you on your abilities but instead trying to better understand your injury or condition so we can develop the best treatment plan for your needs.

Part 3: A Personalized Treatment Plan

In fact, that treatment plan is how we finish up your initial session. We’ll develop a customized program based on all the information we gathered throughout the appointment. That way, you’ll be ready to get started at your next session!

If you’re dealing with pain or discomfort, don’t put off visiting Soleil Physical Therapy & Wellness Inc. Call us for an appointment today.

Sources

• https://www.ncbi.nlm.nih.gov/books/NBK507908/,
• https://www.ncbi.nlm.nih.gov/books/NBK542314/