Sciatica: Causes, Symptoms & Osteopathic Care
Sciatica is a term that describes pain radiating along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. It's a common yet often misunderstood condition that can range from a mild ache to sharp, debilitating pain.
Osteopathy offers a holistic (whole-body) and effective approach to managing sciatica. Instead of just masking the pain, we focus on identifying and treating the underlying musculoskeletal causes to provide lasting relief and restore function.
Key Facts About Sciatica
Prevalence: Sciatica is a common presentation, with studies suggesting its lifetime incidence ranges from 10% to 40% of the population.
A Symptom, Not a Diagnosis: It's crucial to understand that sciatica is a symptom of an underlying condition irritating the sciatic nerve, not a diagnosis itself.
Recovery: Most acute cases of sciatica resolve with conservative management within a few weeks. However, proactive care can help prevent recurrence.
Common Causes of Sciatica
Sciatica occurs when the sciatic nerve is compressed or irritated. The most common causes include:
Lumbar Herniated Disc: This is the most frequent cause. The soft inner material of a disc in the lower spine leaks out and presses on the nerve root.
Piriformis Syndrome: The sciatic nerve can run underneath or, in some cases, through the piriformis muscle in the buttock. If this muscle becomes tight or spasms, it can compress the nerve.
Degenerative Disc Disease: Age-related changes in the spinal discs can lead to a reduction in disc height, potentially narrowing the spaces where the nerves exit the spine.
Spinal Stenosis: A narrowing of the spinal canal in the lower back, which can put pressure on the nerves.
Spondylolisthesis: A condition where one vertebra slips forward over the one below it, potentially narrowing the nerve opening.
How Can Osteopathy Help with Sciatica?
Osteopathic treatment for sciatica is centred on a whole-body assessment. We aim to identify the specific structures compressing or irritating the nerve and address the biomechanical dysfunctions that led to the problem.
During your initial consultation, we will:
Take a detailed history to understand the nature, location, and behaviour of your pain, as well as your daily activities and health history.
Perform a comprehensive physical examination including orthopaedic and neurological testing to assess your nerve function, muscle strength, and reflexes.
Evaluate your posture, gait, and mobility of your spine, pelvis, and hips to identify areas of restriction, muscle imbalance, or joint dysfunction.
This thorough assessment allows us to develop a personalised treatment plan.
What Does Osteopathic Treatment Involve?
Using a range of gentle, hands-on techniques, we aim to:
Reduce Nerve Compression: Through gentle mobilisation of the lumbar spine and pelvis, we can help create more space for the nerve to exit freely, reducing direct irritation.
Alleviate Muscle Tension: Soft tissue massage, myofascial release, and stretching techniques are used to relax tight muscles contributing to the problem, particularly the piriformis, hamstrings, and muscles of the lower back.
Improve Joint Mobility: Articulation and gentle manipulation techniques can improve mobility in stiff spinal joints and the sacroiliac joints, restoring normal movement and reducing stress on the area.
Provide Advice and Rehabilitation: We offer guidance on posture, ergonomics, and specific exercises to help manage your symptoms, support recovery, and prevent future flare-ups.
When to Seek Immediate Medical Help
While osteopathy can be highly effective for most mechanical causes of sciatica, it is vital to rule out more serious conditions. Please seek urgent medical attention from your GP or a hospital if you experience sciatica alongside any of the following "red flags":
Cauda Equina Syndrome: This is a rare but serious condition requiring immediate surgery. Symptoms include:
Loss of bladder or bowel control (incontinence or retention).
Significant weakness, numbness, or loss of sensation in both legs.
Numbness in the saddle area (around the genitals and anus).
Severe or Progressive Neurological Deficit: Sudden, severe weakness or numbness in a leg or foot.
Trauma: The pain follows a significant injury, such as a car accident or a fall.
Systemic Symptoms: The pain is accompanied by unexplained weight loss, fever, or chills, which could indicate a more serious underlying illness like an infection or tumour.
Take the Next Step Towards Relief
Living with sciatic pain can be frustrating and limiting. Osteopathy provides a safe, non-invasive, and drug-free pathway to not only alleviate your pain but also to address the root cause and empower you with strategies to maintain your spinal health.
Click here to schedule an appointment at Nudge Osteopathy. Let us help you get back to moving freely and living without pain.
References
1. Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2023 May 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/
2. Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ. 2007 Jun 23;334(7607):1313-7. doi: 10.1136/bmj.39223.428495.BE. PMID: 17585160; PMCID: PMC1895638.
3. Lewis RA, Williams NH, Sutton AJ, et al. Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses. The Spine Journal. 2015;15(6):1461-1477. doi:10.1016/j.spinee.2013.08.049
Disclaimer: This blog post provides general information only and is not intended as a substitute for professional health advice, diagnosis, or treatment. Always consult a registered health practitioner, such as your General Practitioner (GP) or osteopath, for diagnosis and treatment of health conditions. The information provided is based on best available evidence but should not be relied upon as a sole source of information. Individual results from osteopathic treatment may vary based on the individual’s specific condition and response to care.
