Physiotherapy for sciatica hip pain will depend on your symptoms and goals of treatment.
If you have an acute injury, for instance after a fall on your buttocks, we would use electrotherapy modalities like ultrasound and laser to help with swelling and support the healing process. We might also use acupuncture or dry needling and soft tissue massage to relieve muscle spasm in the painful area. Strapping with kinesiology tape or rigid taping is useful for pain relief and when we start with strengthening exercises.
If your injury had a more gradual onset we will need to eliminate aggravating factors first. This could be anything from changing how you sit when you work on your computer to the position you sleep in.
How often you come for treatment will depend on how your pain started. If you had an acute injury we will need to see you twice a week for pain relief and once a week after that for rehabilitation. You will need 4 to 6 treatments over a period of 6-8 weeks.
For sciatica hip pain that developed over a period of time we will also see you twice a week, initially, but your rehabilitation might take up to 12 weeks. When your pain settles we will see you once a week. As pain the goals of treatment move towards rehabilitation, rather than pain relief, we will see you every second week to check on your progress and change your exercises.
The speed & intensity that an impulse can travel along your nerves are called conduction. When nerve’s impulses are interrupted from nerve injury, we must ensure your nerves can relay a message across your body. Like a cellphone with bad signal. Our treatment works on the pinched Sciatic nerve to restore its conduction.
Motor unit recruitment
When a muscle should contract the brain sends a message to a motor unit in the muscle. When the impulse reaches the motor unit, other motor units automatically fire, leading to a stronger muscle contraction. This is called motor unit recruitment. If you have pain, the motor recruitment is decreased, so you have a weaker muscle contraction. In our treatment we will use motor control exercises to restore the normal muscle contraction. This is especially important to make sure that your movements are synchronized and that muscles fire in the order that they should to prevent compensation later on.
Another important part of your treatment will be to ensure unobstructed glide of the nerve during movement. The sciatic nerve leaves the spinal cord through an opening and passes through different muscles as it runs down the leg. Each of these areas could possibly pinch the nerve and we will treat the whole nerve to make sure it can move the way it should.
During our assessment we will identify where the nerve is pinched and this will determine our treatment techniques. We may use spinal mobilisations to improve vertebral joint movement, massage and dry needling to treat muscles that irritate the nerve and electrotherapy to support the healing process.
Full range of movement
Before the end of your rehabilitation we will make sure you have full range of movement under muscle tension. This means that we will add exercises that put the nerve under tension to make sure your pain doesn’t flare up again. For instance cycling uphill or doing weighted deadlifts.