Sciatica

Written by Dr. David Howard – B.Sc. (Clinical Sci.), M.H.Sc. (Osteopathy), B.App.Sc (Human Movement) from Pascoe Vale Osteopathy located in Pascoe Vale, Melbourne, Victoria, Australia.

Sciatica is a set of symptoms rather than a specific diagnosis. The symptoms are generally buttock pain and a sharp pain down the back of the thigh and sometimes into the calf.  Occasionally, when severe, there may be numbness, muscular weakness and tingling in the leg.

The sciatic nerve is the largest and longest nerve in the body. It originates from 5 smaller nerves from the spinal cord in the lumbar spine (lower back) and passes through the pelvis, buttock and into the leg.

The symptoms of sciatica are produced by pressure onto the nerve which decreases its ability to function and causes pain. There are many different causes of sciatica as there are many different parts of the body where it can become compressed.

Here I will outline a few of these causes:

Piriformis Syndrome

When the sciatic nerve passes through the pelvis, it travels through, under or over the piriformis muscle.  If this muscle gets tight, it can then compress the nerve. This is one the most common causes of sciatica and is easily treatable with osteopathic manual therapy and stretching.

Disc bulge or prolapse

This topic is also covered elsewhere on this website – click here for further detail. The spine discs are like shock absorbers between the vertebral bones. The disc can bulge and compress one of the 5 smaller nerves that make up the sciatic nerve as they exit the spine. This can be quite a serious condition causing severe pain, numbness, tingling and weakness in the legs.

Pregnancy

In the later stages of pregnancy, the uterus itself can compress the sciatic nerve causing the symptoms. Due to the change of posture and extra strain on the body, trigger points, piriformis syndrome and sacroiliac dysfunction are more likely to occur (these are described below).

Osteophytes (bone spurs)

As part of the process of arthritis, bone spurs can grow on the vertebrae.  These bone growths can press on nerves as the exit the vertebral canal, therefore causing the sciatica symptoms.

Here are some causes of Pseudo-sciatica. This is a condition that can have symptoms like sciatica but have nothing to do with the sciatic nerve at all.

Trigger points

The pain experienced is actually referred pain. This means that the pain is felt somewhere distant from its cause/origin. A trigger point occurs when a portion of the muscle becomes ischemic. This means that it hasn’t had enough blood supply. This can occur with injury or long term muscle tightness. Trigger points causing sciatic-like symptoms are most commonly found in the ‘glute’ (buttock) muscles or in the deep hip muscles.

Sacroilliac joint dysfunction

The sacroiliac joints are the two large joints at the back of the pelvis (either side). These quite commonly become inflamed or irritated and may cause referred pain in the lower back, around to the groin, or down the backs of the thighs.

So what can you do about it???

*Always sit with good posture and both your feet on the ground.
*Never sit with your wallet in your back pocket – you are just asking for piriformis syndrome!
*Lift properly. This means using your legs, not your back. The fastest way to get a disc bulge is to bend forward, twist then lift something.
*Keep your weight within the normal healthy range so you’re not putting extra pressure on your discs and pelvic joints.
*Get treatment and advice. Osteopathic treatment can assist with all causes of sciatica and pseudo-sciatica explained above.

 

Disclaimer: Information provided in this post is of a general nature and should not be used solely in place of individual advice from either myself or another medical professional. Pascoe Vale Osteopathy and Dr. David Howard will not take responsibility for any injury resulting from following information in this post.

Pascoe Vale Osteopathy provides osteopathic services to patients from a wide number of suburbs such as Pascoe Vale, Essendon, Essendon North, Moonee Ponds, Strathmore, Niddrie, Keilor, Coburg, Brunswick, Oak Park, Glenroy, Airport West, Travancore, Melbourne, Australia.