So I have felt compelled to write a short blog post on this overused term “sciatica” and how frustrating it is when patients have been told this is what they have. As a patient it gives you no information other than telling you that your sciatic nerve is inflamed (at some point along its very long journey!!). And it absolutely tells you nothing about why it got there, and therefore you are completely disempowered to be able to do anything about it.
Unless you know the cause of your pain or issue, you will never be able to fix it, and escape from your “diagnosis”.
Often when people come to me in acute debilitating pain, they have been given the diagnosis of sciatica, often with a prescription for some high strength painkillers or anti-inflammatories and told to rest. Obviously you don’t want to be running any marathons at this time, but gentle mobility, movement, walking is needed.
So, what is it?
Hayley our senior osteopath has written a nice succinct article on sciatica in one of our other blogs so do take a quick read of this. But sciatica is when the sciatic nerve becomes inflamed, compressed, pinched, irritated or annoyed at some point along its journey. It exits the spine right at the bottom in the lumbar and sacral area at the base of the spine, so can get irritated at its point of exit, or along its path, through the buttock and down the leg. However, unless we know why the nerve has become irritated we cannot get rid of it.
It is mostly caused by a change in load through the spine and pelvis, and often over a period of time, so the altered mechanics place pressure through the nerve or the spinal segments repetitively, and over time they become inflamed. Sometimes we are able to withstand quite a lot of compensation for a long time until a very small event tips us over the edge “the straw that broke the camel’s back”…. Something small like a sneeze, or something more significant like the growing bump through pregnancy.
So we look at how you move, how you walk, how your spine moves, how your feet bare load. We assess how you sit, work position, how you carry your children, breathing, exercising….. We look at the mechanical causes to the sciatic nerve becoming irritated so we can remove these and give you the information about your body, and why it happened, to give you the knowledge of what to do to prevent it coming back.
As osteopaths we use hands on treatment involving massage, stretching, articulations, mobilisations, acupuncture when needed/desired, and taping. We give you advice and exercises to do to prevent it coming back. Our aim is to empower you with the knowledge of your body, not just to get rid of the symptoms (although we do this too!!).
Spinal and pelvic assessment
We treat a lot of people at the acute “agonising” point of sciatica and can make huge differences within one appointment for many people who walk (or hobble/crawl) through our door. It really does work, and the NHS and NICE also support this.
Come see an osteopath here and get to the crux of your pain. You will learn about your body, and what to do to prevent it coming back. We are on your side, and we absolutely love what we do.
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Do you have a rib head subluxation??
Oooh sounds a lot worse than it is.. Honestly!
Do you have pain at the base of the neck coming into the shoulder, by the upper spine, or even described as being behind the shoulder blade, worse with particular positions and neck movements? These are often signs that a rib is “out”. This can then develop into headaches or radiating symptoms down the arm and around to the sternum depending on how long they have had it for.
This must be something that I “adjust” or “put back in” on a daily basis. But many don’t even realise they have it.
Here is a great little article about it and a useful picture below taken from :
People come in with pain at the points circled in red, but often slightly higher in the shoulder too. This can come on from daily activities which may put it at a vulnerable position in some, but also through trauma for example a RTA or a fall. More often than not these areas of pain are indicative of a rib head out of place (popped out, or subluxed). See in this picture below of the rib head and how it connects to the spine :
Once found, these can be relatively easy for us to adjust back to where they should be, but quite often hard to keep there from a patient’s perspective. We would always address the issues that have caused it in the first place which can involve the mechanics of the entire rib cage, shoulder position and mobility, restrictions in the neck and upper back are common features and causes. These will help but there are a number of activities that may predispose us to pop our ribs back out again whilst they are still healing:
~Carrying a child or heavy bag on one side
~Sitting over a computer with rounded shoulders and head forward for long periods
~restrictions through the upper back and neck (place altered forces through the joints with the ribs)
~Walking around typing on a phone in one hand.
~Poor or uncomfortable feeding positions in new mums
Interestingly I have found this to be most common in postnatal mums due to the change in ligamentous laxity but also due to the altered mechanical demands on the body, feeding for hours on end in the early days, along with increased weight of breast tissue. So advice on the correct feeding position is always part of the after care advice here, along with ice and mobilisation exercises.
Healing can take up to six weeks due to the ligament strain associated with the rib subluxation. So although the initial acute pain can be reduced significantly after one appointment you need to follow advice in the following weeks to prevent it from coming back to often.
So great advice as per the linked article above. Use frozen peas, think about not sitting for too long in one position, avoid spending too much time with your phone in one hand, and stay mobile!
Come and see us if and when you need us.
TMJ dysfunction?? Pain in the jaw?? #osteopathyworks
The TMJ (temporomandibular joint) is your jaw joint, and it connects myofascially through to the top for your cervical spine (neck), and to the base of your cranium (skull). Therefore we see many headaches which in fact are a culmination of jaw dysfunction, neck and upper back issues all in one.
With headaches we look at the whole picture as to what is causing the headache. If the TMJ is the main culprit, then this usually relates to periods of stress (where we may be clenching or grinding our teeth without realising), also recent dental surgery or a history of considerable dental work. We also have patients visiting us specifically for jaw pain, sometimes this feels like deep pain by the ear, or an inability to open the jaw properly, or an excessive clicking.
Often the jaw can become misaligned, and disproportionate amounts of tension through the muscles which work on the jaw, as well as interconnecting muscles and soft tissue. This can be exacerbated with hypermobility syndrome.
Osteopaths have a variety of techniques which can be used to release tension and to help realign the jaw, as well as the associated structures. We have found it responds incredibly well, most people have reported a significant improvement in symptoms and pain in just one treatment.
This article “The efficacy of musculoskeletal manual approach in the treatment of temporomandibular joint disorder” also helps to provide increasing evidence to support the use of osteopathy and manual techniques for jaw pain and dysfunction, and concluded that musculoskeletal approaches can be effectively used for TMJ dysfunction and pain, which reflects the outcomes in our clinic.
“The efficacy of musculoskeletal manual approach in the treatment of temporomandibular joint disorder”
Any questions, please feel free to contact us.
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