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What is Sciatica and how do osteopaths treat it?

One of the most common complaints we see is sciatica. Rather than a formal diagnosis, it’s a collection of symptoms stemming from the sciatic nerve. This nerve runs from the lower back into the buttock and down the back of the thigh. It splits into two at the knee, with one branch running down the back of the calf, and one around the front or side. Symptoms tend to follow the course of the nerve.

Leg and back pain

The sciatic nerve can be irritated anywhere along its route. Not all cases are due to a problem in the back. Despite this, people often assume that pain in the leg is the result of a bulging disc. Frequently, these symptoms are actually related to tightness in one of the muscles in the buttock: piriformis. Everyone’s anatomy is slightly different, and sometimes the sciatic nerve runs through the muscle itself. If the muscle then becomes tight for whatever reason, the nerve is quickly compressed.

Causes can be more complicated too. This is why we take a detailed case history: among other things, trauma can lead to injuries that impinge the sciatic nerve. If so, your osteopath may prefer you to see a doctor before coming for treatment. You are welcome to get in contact with us if you are unsure.

Sciatica is a common, yet often misunderstood condition.

Defining Sciatica

Sciatica describes a set of symptoms associated with the sciatic nerve, the longest and widest nerve in the body. This nerve begins in the lower back, running through the hips, buttocks, and down each leg. A solid understanding of the sciatic nerve's anatomy is crucial to comprehend sciatica's nature.

Given its prevalence, recognizing sciatica's signs and understanding its impact can lead to quicker, more effective care. This article is tailored specifically for non-medical audiences, aiming to make the information widely accessible and useful. To grasp the essence of sciatica, you need to understand the sciatic nerve's basic structure. Beginning from the lower spine, branching down into the legs, this nerve important in leg movement and sensation.

Symptoms of Sciatica

Sciatica typically manifests as pain, numbness, or tingling radiating along the sciatic nerve's path—from the lower back, through the buttocks, and into the leg. The severity can range from mild to extreme, usually affecting one side of the body.

Unraveling Causes and Risk Factors

Common Triggers

Various conditions can provoke sciatica, with herniated discs and spinal stenosis being primary culprits. Other contributors include piriformis syndrome, certain pregnancy stages, and more.

Risk Factors

Age, obesity, sedentary lifestyle, and certain physical jobs increase sciatica risk, highlighting the need for targeted prevention strategies.

Diagnosing Sciatica

Recognizing Warning Signs

Key symptoms demanding prompt medical attention include ongoing severe leg pain, weakness, or numbness.

Diagnostic Expectations

Healthcare providers typically conduct physical examinations, review medical histories, and may request imaging tests to confirm sciatica. Timely diagnosis is key to effective treatment.

Exploring Treatment Avenues

Milder sciatica can often be managed with home remedies, including specific stretches, walking, and hot/cold therapies. For severe cases, osteopathy, medical treatments like medications, physiotherapy, or even surgery might be necessary, aiming to relieve pain and encourage healing.

Home Management of Sciatica

Illustrated exercises and video tutorials for safe stretching and strengthening can be effective in managing and preventing sciatica flare-ups. Adjustments in diet, posture, and workplace ergonomics are crucial in controlling sciatica symptoms.

The Role of Osteopathy in Sciatica Management

Understanding Osteopathy

This holistic approach to health focuses on the musculoskeletal system. Osteopaths use manual therapy to diagnose, treat, and prevent ailments like sciatica, aiming to improve overall health.

Osteopathy's Approach to Sciatica

Osteopathic techniques for sciatica include manipulation, stretching, and massage to ease muscle tension and lessen nerve pressure. Osteopaths also provide tailored advice on posture and exercises.

Advantages of Osteopathy

As a non-invasive approach, osteopathy addresses sciatica's root causes and can be a standalone treatment or complement traditional medical therapies.

Symptoms of Sciatica

Typical nerve irritation symptoms can include:

  1. pins and needles

  2. numbness

  3. weakness

  4. a sharp or shooting pain

Some people might also report a burning or stabbing pain. Symptoms tend to focus around the nerve, but some may spread around the leg. If you have these symptoms in the front of the thigh, you may have irritation of another nerve instead. Management of this will be similar to that for sciatica.

Diagnosis and Management

Your osteopath has a number of tests to hand to diagnose sciatica and identify the possible cause. You might think that the most accurate way to diagnose sciatica is to have a scan, but this is not the case. After the age of 40, most people have at least one bulging disc. However, most people over 40 do not suffer from symptoms of a bulging disc. Routine imaging is not recommended for simple back pain or sciatica: false positives can lead to unnecessary interventions, and failure to treat the real cause of the pain.

During your appointments, you can expect your osteopath to work on both the causes of your pain, and managing the symptoms themselves. You may be given exercises or lifestyle advice to help between appointments too.

For longer term pain, treatment may look different. Chronic pain is defined as pain that has been present for at least three months. The brain begins to process pain differently after persistent exposure, so we may need to work more on the nervous system than the muscles and joints. Sometimes osteopathy can work very well alongside less conservative interventions like nerve blocks or strong medication. Other times, people come to us having tried everything else and looking for a different approach. You might find that a more holistic treatment plan is what you need to get past your sciatica.


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