Sciatica
Sciatica is referred pain usually caused by trapping the sciatic nerve in the lower back.
The sciatic nerve runs from the lower back down through the buttocks and along the back of each leg. Sciatica is pain along this nerve and is a relatively common form of back pain and is usually caused by pressure on the sciatic nerve from a herniated or bulging disc.
The pain from sciatica can be anything from infrequent and irritating to severe and debilitating. Usually, it affects only one side, the pain radiating through the buttock and down the leg and is often associated with a constant pain on one side of the buttocks, pain in the leg and/or buttock that may be worse when sitting, burning or tingling down the leg, weakness, numbness or difficulty moving the leg or foot or a shooting pain that makes it difficult to stand up.
While sciatica can be extremely painful and uncomfortable, it is rare that permanent nerve damage (tissue damage) results. Most pain is due to inflammation and will improve within a period of time. Nerve pain is caused by a combination of pressure and inflammation on the nerve root, and treatment is centred on relieving both of these conditions.
Typically, sciatica is made worse by bending, lifting, sneezing and coughing.
Sciatica is a common problem for manual workers, sedentary office workers and is particularly prevalent during pregnancy.
Osteopathic treatment main objectives are
- reduce pain
- restore movement
- strengthen weakened muscles
- reduce tension
Causes of Sciatica
The sciatic nerve is the main nerve in the leg and the largest in the body. It runs from the base of the spine, along the back of the thigh to the knee, where it divides into branches.
Sciatic pain is usually caused by compression of this nerve root at the point where it leaves the spine. Damage to the nerve can also cause pain.
In young and early middle-aged adults, the most common cause of sciatica is a prolapsed intervertebral disc in the lumbosacral area of the lower back.
In older people, changes in the spine due to conditions such as osteoarthritis may be responsible either by causing localised pressure on the nerve or by narrowing of the spinal canal – called spinal stenosis.
Other bone disease or local injury may also be responsible.
Pressure on the sciatic nerve can result from a number of reasons including
- Sometimes, just sitting awkwardly can cause sciatica.
- Piriformis syndrome (tightness of the piriformis muscle in the buttock that compresses the sciatic nerve)
- Spinal misalignments, vertebral dysfunction
- herniated disc
- Poor posture – wearing high heels, prolonged sitting, poor mattress
- Poor lifting technique and poor bending habits
- Spinal compressions due to osteoporosis
Diagnosis of Sciatica
Since there are many disorders that can cause sciatica, your Osteopaths’ first task is to determine the exact cause of your sciatic nerve interference.
Osteopathic treatment
- Always begins with a thorough history,
- Spinal, orthopaedic and neurological examination.
- Special diagnostic imaging investigations such as X-ray, CT, MRI
- Posture pro scan may also be required to accurately diagnose your sciatica.
As sciatica is due to pressure on the sciatic nerve, it stands to reason that treatment involves removing this pressure. Osteopathic treatment aims to achieve this by reducing nerve pressure caused by poorly moving spinal joints as well as easing muscular tension in the lower spine, buttock and leg.
This is achieved by using a combination of the following techniques:
- Spinal mobilisations
- Massage therapy and trigger point therapy
- Stretching tight muscles, joints, tendons and ligaments
- Advice in relation to how to minimise pressure and irritation of the sciatic nerve
In addition to this, you will be given a series of home stretching exercises and asked to apply ice and heat to help aid your recovery.
If you are suffering with sciatica at the moment please do not delay – you can achieve the best results when you address the symptoms early!