Sciatica is a type of nerve pain. The sciatic nerve is a big nerve (about the size of an adult’s pinkie) that controls the function of the leg. It passes from a number of vertebra in your lower back, tranverses through your buttock, close to a big muscle here called the Piriformus and then down into your leg and breaks into branches that end in your foot.
What causes Sciatica?
It is caused by pressure.
That pressure can be in the form of a disc hernation (see article on this), the Piriformus (buttock muscle) spasm, bony spurs around where the nerve exits the vertebral column, arthritis of the back joints, or pressure in the form of inflammation.
Normally it is a burning pain or deep ache that is felt in the buttock, thigh, calf and ends in the foot. The pain may vary from mild to extremely painful and may exist with or without lower back pain. Pins and needles and/or numbness can accompany the pain.
It can be aggravated by coughing, sneezing, straining on toilet or lifting.
What are the risks?
Fortunately most cases resolve slowly over 4-12 weeks.
Signs to lookout for are weakness in leg, especially on walking, not being able to bend ankle or lift your toe.
Conditions that require immediate medical attention are rare, however if you experience heaviness in both legs, numbness in the saddle area ( area that your body comes in contact with if sitting on a saddle), loss of bladder or bowel control, you need to contact a GP urgently.
What is treatment?
Position of comfort and varying this- lying all the time is generally not ideal. It is best to break this time up with moving around as best as you can.
Medication-Normally in the initial acute phase medication is required to help cope with the pain.
Manual therapy-After examination and questioning, your Osteopath may perform specific gentle work; this may help your body calm and get through acute phase. This treatment is often accompanied by advise regarding posture, exercise etc.
Investigation-Your Osteopath, based on your presentation will guide you as to whether CT Scans or MRI Scans are required.