What is Sciatica?
The term sciatica means that the sciatic nerve is being compressed somewhere along its pathway. This is used to describe a group of symptoms. There are many possible causes of sciatica, some of the most common are due to a bulging or prolapsed disc.
Causes and Symptoms
The disc can cause mechanical compression directly on the sciatic nerve or the inflammation caused by the damaged disc can lead to irritation of the sciatic nerve. This pinched nerve can lead to very painful symptoms. Severe pain shooting down the leg is most common. This is often accompanied by altered sensation and even muscle weakness. If this weakness gets worse, consult your doctor. Any alteration in bladder or bowel function (i.e. loss of sensation when going to the toilet) means urgent medical care is needed. Acute back pain is also common due to damage to the disc.
People often describe this as a slipped disc. This is a misleading description. What actually happens is that the pulpy contents of the disc bulge out, pressing on one of the spinal nerves. The bulge itself can be painful and cause localised back pain. This is often referred to as discogenic pain. If it presses on a spinal nerve as it exits the spinal canal, pain can be felt in a more distant area such as the arm, leg, hand or foot.
Arthritis can cause sciatic type symptoms as little bony growths can cause compression on the nerve. This can be due to previous injuries or just the normal process of ageing. Symptoms gradually get worse over longer periods of time and after being in certain positions for prolonged periods.
However, it does not have to be as serious as a slipped disc or arthritis to cause sciatica. Minor muscle tightness can press on the sciatic nerve which can cause severe pain down the leg. Reasons for this can range from sitting in a chair with poor support to compensation due to pain in the knee or ankle.
Treatment is totally dependent on what the underlying problem is. If the cause is a muscle then it is normally very straightforward to treat and recovery time is quick. If the sciatica is due to disc damage, treatment initially has to be fairly conservative. Emphasis is placed on restoring some movement within the spine and reduce pain. This is a very important stage as studies have found getting moving sooner is better for long term recovery. Your osteopath can aid your movements in many ways but not necessarily by working the affected area. Working higher up in the back and through the hips can help your body to compensate and adapt. Advice regarding your posture and, gradually, stretches and rehabilitation exercises will be introduced.