If you ‘Google’ sciatica which the chances are you already have, the definition of sciatica is described as; pain affecting the back, hip and outer side of the leg, caused by compression of a spinal nerve root in the lower back, often owing to degeneration of an inter vertebral disc.

Let’s start by firstly explaining that sciatica is not a diagnosis but it is classified as a symptom as it occurs due to there being a problem else-where in the body, typically the lumbosacral region. Sciatica is extremely common as it occurs in at least 40% of adults irrespective of gender. The sciatic nerve is the longest and largest nerve in the body and can reach thickness of up to a quarter of an inch. It is responsible for bringing your heel up to your buttock as well as contributing to the sensation in your lower leg and foot.

Sciatica can be described in many ways, some of the common terms are a deep burning in the buttock of the affected side, tingling and altered sensation in the leg of the affected side and very occasionally weakness to the affected side. Sciatica typically translates to leg pain, or pain affecting the hip and travelling down the leg. Now there are a number of structures that could be causing this symptom of sciatica which we go into more detail as follows. It is our job as your Osteopath to discover which structure is causing your sciatic pain.

What causes sciatica?

  1. Disc herniation/ bulge (slipped disc): Disc injuries are extremely common within the ages of 22-55 years of age but it is not something that should be feared, depending on the severity it will get better. Research shows manual therapy and exercise prescription is the best aid in recovery. Disc injuries occur due to abnormal loading and compression within the body due to posture changes or repetitive strain patterns which can cause the inner fluid part of the disc to protrude through the outer fibres of the disc and interfere with the exiting nerve roots at that level.
  2. Piriformis syndrome: The piriformis muscle sits deep under your gluteal (buttock) muscle and spans from the side of your sacrum to your outer hip. This muscle is significant in relation to the sciatic nerve as the sciatic nerve can either run above, below or even through the piriformis muscle. Any change to the muscle can result in irritation to the sciatic nerve and cause sciatica. This is very often missed in diagnosis but luckily is much easier to treat.
  3. Degenerative disc disease (DDD) or spinal spondylosis: Unfortunately as we all know degeneration is a process that occurs as we age, however our age does not directly correlate wit degeneration. If we have had repetitive injury or a sedentary lifestyle this process may be more present than if not. DDD occurs when anatomical changes occur to the discs (dehydration), joints of the spine (bony spurs) which surround the disc and surrounding soft tissue (muscle hyper tonicity). These anatomical changes restrict movement through the spine. If the spinal segments are restricted adequate nutrition and drainage of surrounding areas is not sufficient.
  4. Spondylylothesis: This is probably the least common but it is where there is an anterior slippage of one spinal vertebral segment over the one below. This can occur at a varying degree and is graded 1- 5. Depending on the severity, surgery may be appropriate in order to provide support and structure to the spinal column and surrounding structures but this is rare and usually with clear imaging and the all clear for treatment we are very good at managing this condition and the symptoms associated with it.

Your Osteopath can help you with the above and provide you with effective treatment should your case be appropriate. In order for you to reach your potential your Osteopath will take a thorough case history, carry out an in depth examination which includes an Osteopathic, Orthopedic and Neurological assessment. You will then receive our best recommended treatment plan and advice in your Report of Findings, followed by treatment.

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