Sciatica and How Osteopathy can help
We Melbourne osteopaths, often have patients coming to us complaining of sciatica looking for help! They may also be complaining of lower back pain and other associated symptoms such as pain, weakness and discomfort in the leg and foot. The pain can be quite debilitating and can be constant, sharp, dull and intense.
Often, it is people 25-60 years old who present with sciatica, mainly from either wear and tear in the back or from a more acute and sudden traumatic injury.
Sciatica is a term used to describe a distribution of pain which can run from the lower back, into the buttock, down the back of the thigh, and into the leg and foot. The term sciatica however doesn’t really explain what may be causing the pain or discomfort. It is more like a ‘bucket’ term that can encompass many different conditions that can cause this pain.
Sciatica is actually an irritation of the sciatic nerve. This nerve is a very large nerve, which is made up of several smaller nerves that originate from the spinal cord in the lower back (lumbar spine) and come together to form the one big sciatic nerve which passes through the gluteal region – buttock, and then runs down the back of the thigh and leg.
Causes of sciatica can be from a prolapsed, bulging or slipped disc/s in the lumbar spine, disc degeneration in the lumbar spine, degeneration and arthritis in the spinal joints, muscle spasm in the lower back and gluteal region or even something as simple as a sprained/locked facet joint in the lower back. It can also be present during the mid-later stages in pregnancy, from spondylilsthesis (slipped vertebra), piriformis syndrome, sacroiliac joint dysfunction or other more serious conditions such as a tumour or an infection that may trigger sciatica.
Sciatica symptoms can include a deep seated ache in the lower back, buttock, back of thigh and leg, ie, gluteal, hamstring and calf muscles as well as in the heel and foot. It can also cause a burning pain, pins and needles, numbness and tingling and a sense of weakness in the whole leg and foot. Another common complaint is that the pain is worse with prolonged sitting or standing, when coughing or sneezing or moving by bending forward or arching backwards or any twisting of the back.
Once the reason for sciatica has been determined a treatment and management plan can then be set in place. Treatment can include medication, hands on osteopathic treatment or dry needling, or if more severe, an epidural or cortisone injection into the lumbar spine is generally recommended. Surgery can also be an option if all other conservative methods do not help.
Osteopathic pain management treatment may be beneficial for people with sciatica and we have helped many in our Osteopathic Clinic in Melbourne. As osteopaths, we address the whole body system to improve both symptoms and whole body function. We work on the soft tissue structures such as muscles and tendons, ligaments, and connective tissue, as well as joints. We also incorporate treatment to include creating optimal circulatory and lymphatic drainage to help with any associated inflammation, joint restrictions and muscle spasm. This means that when we treat sciatica we are treating the whole person, not just one site of pain. Techniques we employ can include massage, mobilisation and articulation of joints and muscles, muscle and connective tissue gentle release techniques, and stretching. These all help in turn to off load the sciatic nerve, and irritated underlying lumbar discs, joints and local inflammation.
Self management at home can also include rest, medications (either prescribed by your GP or over the counter medications), natural supplements such as magnesium, fish oil and tumeric to help with inflammation and muscle spasm, using heat and ice packs, being aware of your posture when moving, lifting, sitting, driving, working etc, sleeping in optimal positions with extra pillow support if required, gentle strengthening exercises and stretches prescribed by your osteopath or health care provider.
Experiencing sciatic pain can be quite a painful and scary process, however, with appropriate diagnosis, osteopathic treatment and further home management it can also resolve fully.
There are many different postural exercises that can be given to help strengthen the surrounding area for the lower back, pelvis and gluteal region to stabilize and support the structures in the lower back and offload the sciatic nerve. Please ask us about how we can help you with the correct ones for your sciatic symptoms!
We also recommend you practice good posture, and lifting techniques! Or avoid lifting at all! And AVOID all postures and activities that put strain on your lower back or cause you any pain. If you have a desk job, make sure you are not sitting ALL day. Get up and walk around the office, get a drink of water so you are continually well hydrated and do some gentle stretches. Also having the option of a standing desk can be very helpful too so you can alternate your work stations so you are not in the one position all day! And for females, avoid high heels as this causes a change in the lower back posture and causes a further arch in the back, as well as muscles to tighten in the lower back , gluteal and hamstring regions and this, can cause the sciatic nerve to be irritated even further.
Other forms of exercise can include walking, swimming, pilates and yoga. If you are looking for an osteopath in Elwood, Middle Park, Prahran, Caulfield, Melbourne CBD or any of the South Melbourne Suburbs, contact us and our Melbourne osteopaths will prescribe you the most appropriate and effective types of exercises and best management plan for your condition, symptoms and long term benefit to get you as pain free and mobile as possible!