Sciatic pain, also known as sciatica- occurs when the sciatic nerve becomes irritated or impinged. The sciatic nerve runs from the lower back, through the buttocks and down into the legs.

Is it really sciatica?

Often when people experience pain in the back that radiates into the legs, they think that it may be sciatica. However, there are many other conditions that also may refer pain from the back into the buttocks and legs. Some conditions such as sacroiliac joint (SIJ) dysfunction, somatic referral from the low back, or hip pathologies cause pain in the back and legs, however often this pain doesn’t span past the knee.

When pain runs from the low back and down past the knee- we can try to further differentiate if there is impingement of a nerve at the level of the spine, or if its further down in the buttocks or leg. The nerves arising from our lumbar spine are responsible for supplying the sensation in different areas of the leg, called dermatomes. Often, we can attribute pain to one specific spinal level due to the dermatome in which you are experiencing pain, while sciatic pain more broadly covers the back of the leg with the impingement occurring lower down.

Causes of sciatica:

Sciatica is used as a blanket term for any condition where the sciatic nerve is impacted. Different things that may cause irritation or impingement of the sciatic nerve include herniated disks, degeneration of the spine (including osteoarthritis, spinal or foraminal stenosis, degenerative disc disease), spinal fractures, or pregnancy.

Symptoms:

Sciatic pain symptoms can include burning, electric, stabbing, shooting, or sharp pain in the back, buttocks and back of the leg. It can also be associated with numbness, pins and needles, or loss of strength. Most of the time, sciatic pain will only occur in one leg and may be worsened by walking, coughing, sneezing, or straining.

Risk factors for sciatica:

Sciatic pain due to disc herniation is more likely to occur between the ages of 20-50. As we age, our spinal discs become dehydrated and are less likely to herniate. However, as we get older, sciatic pain is more likely to occur from degeneration such as bony spurs or narrowing of the canals that the nerves pass through.

How osteopathy can help in the management of sciatica:

It is essential to get a correct diagnosis for the cause of your leg pain as this will guide the best management outcomes. Whilst a diagnosis of sciatica can be daunting, sciatica is best treated non-surgically and non-pharmaceutically, whenever possible. Your osteopath can help you with sciatic pain by providing manual therapy to the impacted and surrounding areas, in addition to providing rehabilitation exercises to help with pain relief and keep you moving. Your osteopath will also provide you with lifestyle, postural and ergonomic considerations to help manage your pain.

When to seek help:

While an osteopath may assist you with managing the pain in your back or leg, sometimes you might need further intervention such as pain relief medication, imaging of the spine, or referral to your GP or specialist. This is often when the onset of your pain is traumatic in nature, if you have any changes to bowel or bladder function, or any numbness in the groin or genital region. Our osteopaths work closely with local GPs and specialist so will refer on if needed.