The sciatic nerve is one of the largest nerves in the body, made up of two individual nerves held together by connective tissue; it is a 2cm thick band at its widest! Sciatica usually affects one side of the body, a pain that can span from the lower back all the way to the foot. Some also experience numbness or tingling in the leg or foot, these symptoms can be a sign of irritation or compression of the sciatic nerve.
Sciatica is just an umbrella term for a set of symptoms. It is important to get the correct diagnosis of what is causing your symptoms in order to correctly manage and get the right treatment for your pain.
Intervertebral disc injury
One of the most common causes is an intervertebral disc injury. This may be a disc bulge or herniation, or degeneration of the disc, all of which can compress or irritate the sciatic nerve. Other accompanying symptoms of a disc injury may include back pain, pain on coughing/ sneezing, worsening pain when sitting, pain on transitional movements, or pain that is worse in the morning.
This is a painful condition but will usually recover much quicker than a disc injury. This occurs when a muscle in the buttock, called Piriformis, becomes tight or in spasm and pinches the sciatic nerve. Causes include dysfunction in local joints such as the sacroiliac joint or the hip, sitting for long periods, leading a sedentary lifestyle, or doing regular exercise without stretching.
Other conditions which may mimic sciatic symptoms include a localised hamstring injury, or referral of pain from a the lumbar spine or sacroiliac joints, which can give pain in the back of the thigh, often being incorrectly referred to as ‘sciatica’
In order to diagnose the cause of sciatica an osteopath or other health practitioner will ask you detailed questions about you pain including its daily pattern, aggravating or relieving factors, or what you were doing at the time of the injury. At this stage your osteopath will already have a good idea of what the cause is. To confirm their diagnosis they will carry out orthopaedic and neurological testing to find the culprit!
Following this a treatment plan can be developed with the patient including hands on therapy, stretches, home exercises and advice. We find that it’s very rare that we need to refer a patient for any imaging or further investigations as they get better with conservative treatment. In some sever cases we may refer you back to your GP for further medical help.
Make sure you follow our Facebook page to see our exercise videos for sciatica – coming next week!