Sciatica
Written by Hayley Robinson Senior Associate Osteopath at Herts Osteopathy, St. Albans.
What is it?
Sciatica is the term used to identify pain in a specific region of the body. The sciatic nerve is a large nerve that exits the base of the spine and supplies the sensation and function of the back of the leg starting from the buttock/thigh/calf and ending at the bottom of the foot. The symptoms can present as pain, weakness, altered sensation or a combination of all three in any of the above areas. It is often described as sharp, shooting, electric shock, deep, unremitting and wave like pain that cannot be reproduced in the area it is felt (most commonly the leg).
What can it be caused by?
• Disc bulge/prolapse The most common cause of sciatica is from a disc bulge or prolapse causing compression of the nerve as it exits the spine.
• Spinal stenosis (narrowing of the spinal canal)
• Compression secondary to lumbar spine joint facet irritation and associated local muscle spasm
• Piriformis syndrome- caused by a muscles that sits deep within the buttock spasming which in some cases can cause irritation of the nearby sciatic nerve.
What do we do?
Often when we see patients with sciatica they are in a great deal of pain. Depending on the cause of the nerve irritation is how we determine how to approach and treat the symptoms.
My personal port of call is to calm the area down and provide some relief for the patient. Particularly in acute (early) situations. This will include reducing muscle spasm, gently stretching and articulating the surrounding structures and giving reassurance and home exercise advice that the patient can take away with them.
Areas I look at: I asses the pelvis to ensure it’s aligned, assess the function of the spine as a whole rather then just the symptomatic area. The surrounding soft tissues and what they doing to the symptomatic area. The lower limb (feet/knee/hip positioning) and how they are affecting the function leading up to the spine. Not only this but I also take into consideration predisposing factors such as your job, how you drive, your hobbies, your shoes, your desk set up and even how you carry your bag!
Spinal and pelvic assessment
Osteopathy
Too much I hear you ask?
Not at all!! All of this enables me to see you/your life in a bigger picture which will then allow me to tailor a management plan that suits you best. So not only do I take into consideration your physical presentation I consider factor around had in your life that will enable the best approach to managing your symptoms.
Osteopathy
Evidence?
The NICE guidelines ( the National Institute for Care and Guidance) recommends the following under recommendations for non invasive treatment and management of sciatica (1.2.7)
“Consider manual therapy (spinal manipulation, mobilisation or soft tissue techniques such as massage) for managing low back pain with or without sciatica, but only as part of a treatment package including exercise, with or without psychological therapy”
(Nice guidelines taken from www.nice.org.uk )
All of which an Osteopath can offer!
Here is another article illustrating how Osteopathy can treat Sciatica can be found below:
Osteopathy and Sciatica in the news
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