Sciatica

Sciatic pain or sciatic neuritis is a set of symptoms including pain that may be caused by compression and/or irritation of one of five spinal nerve roots that together form what most people know as the sciatic nerve. The pain is felt in the lower back, buttock, and/or various parts of the leg and foot. In addition to pain, which is sometimes severe, there may be numbness, muscular weakness, pins and needles or tingling and difficulty in moving or controlling the leg or foot. Typically, the symptoms are only felt on one side of the body.
Although sciatica is a relatively common form of low back and leg pain, the true meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than a diagnosis for what is irritating the nerve and causing the pain. This point is important, because treatment for sciatica or sciatic symptoms will often be different, depending upon the underlying cause of the symptoms.

Listed below are just a few of the common causes of sciatic pain, however, is by no means exhaustive. If you feel that you may have any of these conditions or symptoms please feel free to contact the clinic for advice or an appointment.

  • Disc bulge or prolapse- (often incorrectly referred to as a "slipped disc"). There are many causes of a disc bulge/ prolapse, it is most commonly associated with bending, lifting and twisting, however, chronic repetitive strain and overuse is also very common. Osteopaths are very familiar with treating these injuries, the recovery time greatly depends on the extent of the discal damage (commonly between 4-12 weeks)
  • Spondylitis/ Spondylosis- This is a general degenerative spinal condition that we will all suffer from eventually, some earlier than others depending on the level of trauma and strain on the spine during our lives. The term Spondylitis refers to wear and tear in the facet joints at the back of the spine, thinning of the intervertebral discs and narrowing of the ("foramen") holes where the spinal nerves appear from, thus potentially causing nerve irritation/compression (sciatica). Other symptoms associated with this condition are stiffness and reduced mobility of the spine, inflammation in the spinal joints and tight/painful spinal muscles. Osteopathy can help by mobilizing the spine, decompression of the nerves and reducing the tension in the muscles.
  • Spinal Stenosis- a condition wherein the spinal canal (the spaces through which the spinal cord runs) narrows and compresses the spinal cord, cauda equina, and/or sciatic nerve roots. This narrowing can be caused by bone spurs, slippage of a vertebra, inflammation, or herniated disc which decreases available space for the spinal cord, thus pinching and irritating nerves from the spinal cord that travel to the sciatic nerves.
  • Piriformis Syndrome- a condition where the sciatic nerve gets pinched by a muscle in the buttock ("piriformis muscle"). In 15% of the population the sciatic nerve runs through the muscle instead of under it making it easy to irritate especially if the muscle is very tight or in spasm due to altered function of the spine or pelvis. This condition is known as a neuropathy.
  • Trigger points- these are very common and can be found in almost everyone and can cause varying levels of pain. They are classified as exquisitely tender points within a muscle. They are caused by chronic overuse and fatigue in the muscle and result in shortened contracted muscle fibers that can get so painful in some cases they can refer pain to a distant sight/ other parts of the body. Some people refer to these as "knot's in a muscle". The treatment is soft tissue massage, stretching and cryotherapy (ICE).
  • Pregnancy- pressure on the sciatic nerve is common in pregnancy due to the developing fetus growing inside the uterus and taking up increasing amounts of space inside the pelvis and pressing on the sciatic nerve. Other causes are due to postural changes especially in the lower back (lumbar spine) and pelvis associated with fetal development.
  • Sacroiliac Joint Dysfunction/ Sacroiliitis- The SIJ's are the two large joints in the back of the pelvis and are extremely important for spinal stability, mechanics, walking, force transferring and giving birth. They are very well known to osteopaths because they regularly cause problems and are often the root cause of other spinal problems. As the sciatic nerves run directly over each of these joints it is very common that the nerve can be irritated by inflammation associated with SIJ dysfunction and sometimes mimic a disc bulge.
  • Postural fatigue/poor posture-, repetitive strain and overuse, muscular spasms and tears, ligament strains and tears in the lower back and pelvis can also cause the lower back to spasm, lock, inflame and potentially cause sciatic pain too.

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