About Sciatica
We get a lot of enquiries from people asking whether or not we can help them with Sciatica. The good news is that we usually can. However, the majority of the time it isn’t actually Sciatica that they’re suffering with. Sciatica is an often-misunderstood term and isn’t really a problem or condition in of itself. Sciatica is actually only a symptom; the term simply describes pain in the Sciatic nerve. This pain can be caused by any number of underlying problems which are commonly very minor, and only rarely more serious.
What is Sciatica?
The Sciatic nerve is made up of several nerve roots that emerge from the base of our spine. It is the thickest and longest nerve in the body. True injury to the sciatic nerve is less common than you’d expect.
The term “sciatica” is frequently misused to describe any pain that originates in the lower back, with or without pain in the leg. As some of the names of the nerves in the body are quite long Latin terms, it is understandable that for simplicity’s sake, ‘Sciatica’ has been the catch-all term that is generally used for radiating leg pain.
Other nerves that travel into the leg can be injured in similar circumstances. Pain in the outside of the thigh, for example, may be caused by irritation to the Lateral Femoral Cutaneous Nerve, but “Lateral Femoral Cutaneous Neuralgia” doesn’t roll off the tongue in the same way “Sciatica” does. True Sciatica will be felt through the buttock, back of the thigh, back of the calf and sole of the foot. These pains are usually caused by irritation, inflammation, pinching or compression of a nerve in the lower back.
What Causes it?
There are many ways that pain in a nerve can be provoked. At The Courtyard Clinic we most often see it caused by joint strain and associated muscle spasm. For example, the Sacroiliac Joint (the joint between your tailbone and pelvis) or lower Lumbar facet joints (joints in the base of your spine) can become strained causing the surrounding muscles to spasm, this can put pressure on the Sciatic nerve which leads to the pain into the leg.
This is sometimes described as ‘Piriformis Syndrome’, named for the muscle in the buttock that commonly causes the compression. Other causes include disc degeneration, disc bulges, spinal joint inflammation or arthritis, bony spurs, fractures, and tumours. Sciatica can be caused by anything that compresses or irritates the nerve, either at its root where it exits the spine, or along the route it takes to the tissue it supplies.
What are the Symptoms?
Common symptoms of Sciatica include:
- Pain in the low back, buttock, back of the leg and foot.
- Numbness, pins and needles, or weakness in the low back, buttock, leg or feet.
If the root problem begins to put pressure on the spinal cord it can cause a loss of bowel and bladder control and numbness around the groin and anus. This is known as Cauda Equina Syndrome and is a medical emergency that calls for urgent surgical intervention. If patients with Cauda Equina Syndrome do not receive treatment quickly, adverse results can include paralysis, impaired bladder and bowel control, difficulty walking, and other neurological and physical problems.
How is it Treated?
As discussed above, the most common cause of Sciatica is associated with joint and/or muscle strains. Episodes like this are treated quite easily with Physical Therapies such as Osteopathy and Physiotherapy.
Whilst it can be sore for a while, treatment with gentle joint mobilisation, soft-tissue massage and stretching techniques restore range of motion and calm muscle spasm so that symptoms ease quickly. Regular exercises are vital to build the stability and flexibility in the area and prevent reoccurrence.
With some causes, such as with disc bulges or more advanced degenerative changes, physical therapy can still be successful in improving symptoms, but may take a little longer and be more susceptible to relapse. In more severe cases surgery may be necessary, in the event of the Cauda Equina symptoms discussed above, this would constitute a medical emergency.
