Sciatica – What is it and Osteopathic Treatment
Sciatica…I’m sure you’ve heard of it, and maybe even experienced it… It’s not fun!
As Osteopaths, we are experienced in seeing patients with sciatica. It presents to us almost daily, and we can diagnose the cause, help manage and alleviate symptoms and pain associated with sciatica.
Sciatica is a term widely used to describe pain that runs from the lower back, into the buttock region and down the leg. The pain may vary from constant, boring and deep, dull and achy, sharp and shooting, with pins and needles, numbness, and weakness with movement in the leg and foot. The sciatic pain may change with movement or rest and be aggravated by carrying and lifting, as well as coughing and sneezing. It can also cause difficulty sleeping and affect movement and functional activities of daily living such as getting dressed and getting in and out of the car. It really can be so different in so many people.
Sciatica is aptly named as it refers simply to irritation of the “sciatic” nerve. This nerve is a larger nerve that is composed of a bundle of nerve fibers that come from the lower back spinal nerves. These spinal nerves join together in the gluteal (buttock) region and then continues run down the back of the thigh to behind the knee. The sciatic nerve supplies muscle and sensory information to the lower half of the body. Commonly, sciatica affects both men and women in a large age group – from 25-70 years old. This is because there are so many reasons why sciatica can actually occur. Causes of sciatica may include:
- Arthritis and Degeneration (wear and tear) in the spinal joints and sacroiliac joints
- This can include bony changes such as narrowing of joint spaces between lumbar vertebrae (canal stenosis), and bone spurs which press on the nerves in the lower back,
- Acute or Chronic Disc Bulge/Prolapse – or commonly also referred to as a “slipped disc”. This in turn may press on the spinal nerves running down the leg/s causing symptoms,
- Pregnancy related changes in the pelvis, causing muscle spasm, joint sprain, strain and nerve irritation
- Muscle spasm in the lower back, gluteal (buttock) region and hamstring
- Piriformis Syndrome where the piriformis muscle goes into severe spasm and presses or compresses the sciatic nerve directly
- Spondylolisthesis which there is slippage of the vertebral segments on each other which in turn affects the nerves and causes nerve pain
- Or more serious conditions such as a tumor or infection.
Sciatica and Osteopathic Treatment
Sciatica can present in so many ways, and it is best to have the reason for sciatica diagnosed as soon as possible to help understand, manage and alleviate the pain. Your Osteopath will take a thorough medical history of the current pain as well as your previous episodes of pain and other medical conditions that may have some influence on what is causing the sciatica in the first place. Your Osteopath will also perform a series of tests including Orthopaedic testing, active and passive movements of the spine, hips, lower limbs, muscle, joint and reflex testing – all to determine what is occurring in the body and causing or contributing to your pain. Your Osteopath will also determine whether any imaging such as MRI or CT scan is indicated, or referral to a specialist doctor or GP may be required. You may also be in need of pharmaceutical pain relief which we will refer you back to your GP or pharmacist for appropriate advice and medication. An Osteopathic approach to treatment for sciatica will include helping decrease any local and systemic inflammation and pain of the affected local and surrounding area/s. Your Osteopath will aim to:
- Decrease muscle spasm and tightness in the:
- Mid and lower back,
- Hips and pelvic region,
- Lower legs, and
- Improve joint mobility,
- Improve functional movement,
- Improve joint and muscle stability,
- Improve lymphatic drainage of the lower limb and pelvic regions
Once initial acute or even chronic pain and tissue sprains/strains have improved, treatment can progress to exercises and rehabilitation to create optimal mobility, postural strength and muscle activation - all important in the recovery of pain. We will also advise on the use of:
- Heat packs,
- Ice packs,
- Nutritional supplements that may include magnesium, fish oils, turmeric and more,
- Taping or bracing,
- Dietary support for inflammatory conditions
- Appropriate exercises, stretches and strengthening programs
St Kilda Osteopathy can help in correctly diagnosing musculoskeletal issues caused by sciatica and offer you hands on treatment and rehabilitation to aid in your recovery. See us today to learn how we may be able to help you!