Sciatica is the name given to symptoms we experience when the sciatic nerve has been compressed or irritated. It should be recognised that “sciatica” is not a diagnosis but a symptom as sciatica can have many different causes.
What is it?
The sciatic nerve is the longest nerve in your body, originating from the lower back, running through the buttocks, down the legs, and into the feet. When the sciatic nerve is irritated or compressed by any of the structures it passes, you may experience pain down the course of the nerve. Sciatic pain can vary from mild to severe.
What are the symptoms?
Sciatica is pain radiating down the legs, you may experience this in just one leg or in both. In addition to pain, you may also get pins and needles, numbness, and/or muscle weakness which are all signs of nerve irritation.
It is important to note that if you experience other symptoms such as sudden weight loss, inability to stand up (due to legs giving way) or a loss of bladder and bowel control you must consult your GP as soon as possible.
What is the cause?
As mentioned earlier there can be many different causes of sciatica. Some of the causes are as follows:
A herniated or prolapsed disc (commonly known as ‘slipped disc’)
Vertebral discs are found between each vertebrae in your spine. Although they are made of tough fibrous tissue some of the softer centre can prolapse. If you have a prolapsed vertebral disc its contents can protrude and compress on the sciatic nerve, or even just cause chemical irritation to the nerve. All of these can lead to sciatica.
The piriformis is a muscle found deep in the buttock. In around 17% of the population the sciatic nerve runs directly through piriformis. If the piriformis becomes tight then this can compress the sciatic nerve causing sciatic tension and sciatica.
Facet joint dysfunction
Each of the vertebrae in your spine is joined by facet joints (or zygapophyseal joints). A sudden excessive movement of the facet joint or years of constant micro trauma through poor posture or heavy lifting can lead to facet joint dysfunction. This can be a cause of radiating leg pain (sciatica).
A narrowing of the spinal canals through which the nerves run, can compress on the sciatic nerve causing sciatica.
Sacroilliac joint (SIJ) dysfunction
The sacroiliac joints connect the sacrum to the pelvis (or ilium). These sacroiliac joints bear the weight of the entire upper body; in order to carry this weight safely, the SIJ is very rigid with minimal range of movement. At times the SIJ can become irritated due to sudden excessive movement or a steady build-up of muscle imbalance; this can be a cause of radiating leg pain (sciatica).
How can we help?
As mentioned above, sciatica can result from many different conditions in many different structures. We can provide you with a comprehensive assessment in order to differentiate which structures are the cause of your sciatic pain. We will then be able to effectively treat the cause of your pain in order to minimise the chance of recurrence in the future. The following are possible ways in which we might treat sciatic pain.
What types of treatment are available?
Manipulation Therapy can help to release joints that have become stiff and dysfunctional.
Deep Tissue Massage
Deep Tissue Massage can reduce muscle tension, improve tissue mobility, enhance muscle contraction and desensitize any painful and overactive areas.
Core stability exercises
Core stability exercises strengthen the muscles that stabilise and support your back.
Manual Mobilisation Therapy
These are passive movements that the therapist applies to the spine to increase the range of movement, reduce stiffness and pain.
Exercises and Rehabilitation
We can provide you with a tailored exercise programme focusing on your needs in order to maintain/improve both strength and mobility
Acupuncture can stimulate the body’s natural healing response, release pain-killing endorphins and improve the functioning of the neuromuscular system.
Ergonomic and postural advice
This can help you manage your day-to-day activities whether you’re sitting at a desk or trying to get a good night’s sleep.
Ultrasound Therapy can speed up and optimise the healing process.
TENS can be applied throughout the day to provide natural pain relief.