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Sciatica is the name given to pain that runs along the path of the sciatic nerve. This nerve extends from the lower back, through the hips and down into each leg. The sciatic nerve is the longest nerve in the human body, beginning at the lumbar and sacral spinal nerves. The nerve branches out as it moves down, providing sensory and motor function to the lower limbs. It is along this nerve pathway that is affected by sciatica. The condition can develop when the sciatic nerve becomes compressed, typically due to a bone spur, herniated disk or narrowing of the spine (spinal stenosis). In rare cases, sciatica can be present in both legs, however in the vast majority of cases only one side of the body is affected. The symptoms and severity of sciatica can vary from patient-to-patient, ranging from mild discomfort and aches to sharp, shooting pains, often also including tingling, numbness and muscle weakness. Living with untreated sciatica can be debilitating, having a huge negative impact on quality of life, however with the right treatment and knowledge, the condition can be controlled and its symptoms reduced or even alleviated.
The most common cause of the condition is slipped or herniated discs in the spine. These discs effectively act as a buffer, supporting the vertebrae along the spine. When these discs become displaced, it can put additional stress on the sciatic nerve, triggering pain and other symptoms. Below are a number of other common causes and factors that can lead to sciatica.
Spinal stenosis refers to the abnormal narrowing of the spinal canal and can result in pressure on the nerves and spinal cord. The spinal canal houses the spinal cord and runs through each vertebrae. A tightening of this canal can compress the spinal cord, leading to back pain, discomfort and potentially conditions like sciatica
The piriformis muscle is located deep in the buttocks, starting at the lower spine and connecting to both thigh bones. This is an important muscle, tasked with controlling hip rotation and turning the leg outward. The sciatic nerve typically runs directly beneath it, however in rare cases, the nerve can run through the muscle. The piriformis muscle can spasm, causing pain and irritation which can, in turn, affect the sciatic nerve.
Spondylolisthesis is the name given to a vertebrae that has slipped out of alignment relative to the other vertebrae. It is most common in the lower back, however it can occur anywhere along the spine. This slipped vertebrae can irritate the sciatic nerve, potentially leading to sciatica if left uncontrolled.
Any physical injury that results in shock or trauma to the areas of the body near to the sciatic nerve can cause sciatica. An accident may cause a herniated disc, which is where the gel-like core of a disc pushes out and irritates the sciatic nerve. Bone fractures, hip dislocations, foreign objects such as knives or equipment and muscle tears are other common injuries that can affect the sciatic nerve, potentially causing sciatica.
There are multiple treatments available to those who suffer from sciatica. The choice of which treatment method to move forward with is largely dependent on the severity of symptoms and the underlying cause of the condition. For the majority of individuals, a non-surgical method is favoured, however in extreme cases surgical intervention may be required. There are a large number of effective medications that can treat the condition, such as non-steroidal anti-inflammatory drugs (NSAIDs), painkillers, steroid injections and muscle relaxants. Unfortunately many of these treatments are really just masking the pain, rather than getting to the root of the problem through manual therapy.
Hands-on approaches such as physiotherapy and osteopathy can play a crucial role in managing the condition and controlling its symptoms. A practitioner can design a specific exercise and treatment plan, targeting appropriate muscle groups near the lower back and legs. These treatment plans often incorporate stretching techniques that can be hugely effective with reducing the stress on the sciatic nerve.
Deep tissue massage and trigger point therapy are often used to target specific muscles and bring relief by using the gentle application of pressure. This can have a positive effect, not only on an affected area of pain, but also on an individual’s stress and endorphin levels. This can be particularly effective for sciatica when the condition causes tight or tender muscles in the lower back or upper legs.
There are a large number of small, incremental changes we can make in our everyday lives that can both help reduce the risk of developing conditions like sciatica and treat the symptoms from the comfort of our own homes. Being conscious of posture and making a concerted effort to keep your back straight, shoulders back and head up while walking or standing can have a huge impact. Using proper lifting technique, meaning to use your legs to lift heavy objects while keeping your back straight can help reduce the risk of injury. Regularly changing position can also help, this could simply be changing your seating position, or perhaps standing up and walking for a short time. Regular exercise, a healthy balanced diet and keeping a healthy body weight are all small changes that make a big difference.
Please call us and arrange to speak to an Osteopath or Physiotherapist if you are unsure about the nature of your injury or what treatment would be right for you. If treatment is not deemed appropriate there will be no charge made for your appointment.
Osteopathy offers a hands-on, manual therapy approach to the treatment and prevention of musculoskeletal injuries using mobilisation and stretches, deep tissue massage, trigger point therapy and myofascial release to restore the health of muscles, tendons, ligaments and joints.
As the treatment involves massage and stretching techniques you may need to remove some outer layers of clothing such as shirt, jumper or trousers. If you are suffering from low back pain or leg pain you may wish to bring shorts or loose trousers to change into. Women suffering from back and upper limb pain may wish to wear a vest top.
Your initial consultation involves the osteopath or physiotherapist taking a full medical history, treatment notes are then also taken at subsequent visits. Medical histories are kept on our secure practice software in accordance with data protection and the code of practice set out by The General Osteopathic Council and The Chartered Society of Physiotherapists. Medical history and treatment notes are not disclosed to any third party such as General Practitioners or health insurance providers without the permission of the patient.
Osteopaths and physiotherapists are trained as primary healthcare practitioners and patients can seek treatment without referral. If necessary you will be advised to see your GP or you may be referred for further investigations such x-ray or MRI. Please note most Health Insurance companies ask that you contact your GP before seeking treatment.
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