Osteopathy Journals and Research by Darren Chandler

 

Sciatica

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Contents

  • What is the sciatic nerve
  • What is sciatica
  • Can sciatica be cured?
  • When to see your doctor
  • What osteopathic manipulative treatment can do

What is the sciatic nerve?

The sciatic nerve is the largest nerve in the body. It starts from the bottom of the back, travels through both buttocks, down the back of both legs to the feet.

What is sciatica?

Sciatica is when you trap the sciatic nerve. There are 7 different categories of injury that can trap the sciatic nerve. Only a handful of these are really common though.

Pain, pins and needles, numbness, burning or a ‘pulling’ sensation can be felt in either or both buttocks, back or outside of the legs and/or feet.

Sciatica can also be used as a more general term where the sciatic nerve isn’t trapped. This is also known as ‘pseudosciatica’. In this type of sciatica an array of different muscles, joints and ligaments in the low back, pelvis and leg give referred pain that can mimic the symptoms of sciatica. These can all be loosened by your osteopath.

Can sciatica be cured?

YES. Most cases of sciatica are easily treatable. The NHS recommends for non-complicated causes of sciatica(1)

  1. Most cases of sciatica pass in around six weeks.
  2. Home management including over-the-counter painkillers, exercising and using hot or cold packs. 
  3. A structured exercise programme.
  4. Prescribed painkillers.

In private practice we see patients who this standard advice hasn’t worked for. In these cases your osteopath will perform a thorough examination of all the nerves, muscles, ligaments and joints. This will decide what to treat using a hands on approach and home exercises. Occasionally your osteopath might examine you and think a referral to your doctor is more advisable.

When to see your doctor

Most cases of sciatica are easily treatable by your osteopath. This is a list of the most common conditions and the most common symptoms that I see in clinic and would refer to the GP. It does not constitute a complete list of all symptoms and all conditions. If you have any of these symptoms and require a second opinion please consult with your GP.

It is important to remember just because you have any of the following symptoms it doesn’t necessarily mean you have a particular condition. However it is important to see your GP or osteopath to see if you have a condition that needs further investigations or something more minor and easily treatable.

1. Cauda Equina Syndrome (trapped lower part of the spinal cord):

  • Tingling or numbness between your legs, around your buttocks, around the genitals and pelvic floor.
  • Alterations in the passage of stools or urine (incontinence, difficulty stopping and starting, changes in frequency, etc).
  • Difficulty contracting your pelvic floor muscles (the muscles you tense to stop yourself going to toilet).

When experiencing any of these symptoms it is important you consult a doctor as soon as possible

2. Slipped disc

  • Numbness in the leg or foot.
  • Weakness in the foot (difficulty lifting or taking weight on the foot).
  • Pain worse on coughing, sneezing or straining.

 3. Vascular claudication (poor circulation):

  • Pain down the leg on walking immediately relieved by resting.
  • Coldness in the foot or leg.

 4. Spinal stenosis (excessive wear and tear – not exclusive to elderly):

  • Pain in the leg(s) on walking upright eased by walking bent forward.

 5. Systemic illnesses:

  • General symptoms of ill health: fevers, night sweats, unexplained loss of appetite, loss of weight, etc.

What osteopathic manipulative treatment can do

Most cases of sciatica are easily treatable using a combination of various different treatment techniques and home exercises. Because sciatica is such a general term encompassing such a varied range of conditions standard advice whilst good for one condition may aggravate the other with potentially serious complications. Therefore before taking any advice you should be assessed by an appropriate healthcare practitioner.

References

(1) http://www.nhs.uk/Conditions/Sciatica/Pages/Introduction.aspx#treatment

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