Shockwave Therapy for Sciatica

What is Sciatica?

Sciatica is the term used to describe pain that follows the path of the Sciatic nerve. Shockwave therapy for sciatica is one treatment approach for helping manage this pain. Pain is often increased by bending forwards and twisting. It is a common misconception that all radicular pain in the lower limbs is classified as Sciatica. The Sciatic nerve is formed by nerve roots from L4 through to S2 which originate in the lower back, and it is the largest nerve in the body; in some people it can be up to 2cm in diameter.

Sciatica can have several potential causes

Sciatica can arise from a variety of causes, any condition that may structurally impact or compress the sciatic nerve may cause sciatic symptoms. These may be conditions that affect the spine, for example a disc bulge, or compression of the nerve in the Gluteal complex, for example in the case of Piriformis Syndrome. Additionally, other factors may contribute to the development of sciatica, such as torniquets used during surgery, and even exposure to radiation can cause damage to the nerve.

What is Shockwave therapy?

Shockwaves are a type of energy in the form of mechanical waves, as opposed to electrical currents, that has biological effects at the cellular, tissue, and organ level. ESWT is delivered through two main forms: radial shockwave therapy (R‐SWT) and focused shockwave therapy (F‐SWT).

Although we don’t know the exact mechanism of action of shockwave therapy, studies have suggested that some of the ways that extracorporeal shockwave therapy helps is by stimulating proliferation of tendon cells, increase the infiltration of leukocytes (immune cells) increase growth factor and protein synthesis to stimulate collagen synthesis and tissue remodelling.

How can Shockwave therapy for sciatica help?

In a research study in 2021 by HX Li, it was shown that low-intensity extracorporeal shockwave therapy (LiESWT) promotes recovery of sciatic nerve injury. This study showed that more nerve fibres and myelin sheath were found after treatment with LiESWT.

The location of your treatment will be based on the underlying cause of your sciatica. So, for instance, if the source of your pain is in the gluteal region, your physiotherapist may focus treatment there.

What will my Shockwave treatment plan look like?

After assessing your injury, your physiotherapist will advise approximately how many sessions you will need. Research shows that for best results, an optimum treatment protocol for ESWT appears to be three to five treatment sessions, each one a week apart.