Sciatica refers to pain down the sciatic nerve, which runs from the low back down the back of each leg. It is commonly associated with back pain. Sciatica can be disabling, leaving people unable to do simple things like getting dressed, but others may find it an annoying discomfort. Research shows starting physical therapy soon after a sciatica diagnosis could speed recovery.
A clinical trial published in the Annals of Internal Medicine, examined two groups of people with sciatica.
• Usual care group – participants were given a copy of an educational resource that stressed prognosis of low back pain and the importance of remaining active as well as avoiding bedrest.
• Early physical therapy group – participants were given the same resource, but also were referred to four weeks of physical therapy that began after three days of the initial diagnosis.
At four-weeks and six-months follow-up, the early physical therapy group reported greater improvement in pain levels and ability to care for themselves. At the six-month and one-year follow-up, the early physical therapy group reported less disability in daily activities, compared to the usual care group.
The evidence suggests that we cannot expect sciatica to go away on its own and stay gone. Starting a short course of physical therapy right away improves outcomes, even after a year.
Fritz JM, Lane E, McFadden M, Brennan G, Magel JS, Thackeray A, Minick K, Meier W, Greene T. Physical therapy referral from primary care for acute back pain with sciatica: a randomized controlled trial. Annals of Internal Medicine. 2021 Jan;174(1):8-17.