Quite a few of you suffer from sciatica symptoms. Sciatica is a term for symptoms of pain along the large sciatic nerve that runs from your lower spine and down the back of the leg. Sciatica is diagnosed when the sciatic nerve is irritated or compressed by some type of problem in your lower back.
When any of the roots of the nerves in your lower back are irritated, the pain will travel from the nerve root to the sciatic nerve, down to the buttock. It will sometimes track down the back of the leg and into your foot and/or toes.
WHAT DOES IT FEEL LIKE?
People describe sciatic pain as a shooting, searing pain that radiates down the back of the leg. Some people describe the nerve pain as electric-like. Some people will describe it as a dull constant pain. There is sometimes, numbness, tingling, or burning felt along the nerve.
WHAT CAUSES IT?
The most common causes of sciatica in younger adults tend to be a herniated lumbar disc, disc degeneration or spondylolisthesis (a condition where the spine slips out of alignment). In older adults the most common causes tend to be degenerative changes in the spine.
The term sciatica is often misused, people may be tempted to self-diagnose and self-treat incorrectly. It is important to get checked by a professional, your GP, Osteopath or similar practitioner to get a correct diagnosis and get a plan for your ongoing treatment.
WHAT ELSE COULD IT BE?
Many people refer to any type of leg pain as sciatica, but in fact, there are many causes of leg pain that are not medically classified as sciatica and need to be treated differently.
Here are some examples:
Arthritis can refer pain from the joints into the leg, but this pain is not technically sciatica, and the treatment for it is different. Treatment for arthritis, focuses on nonsurgical therapies. The goal is to preserve motion in the joints and reducing pain long term. Anti-inflammatory drugs are often prescribed to reduce joint inflammation.
Sacroiliac joint dysfunction is a relatively common cause of lower back, hip, and/or leg pain. Too much or too little motion in the sacroiliac joints can cause pain that radiates down your leg and feels like sciatica. Treatment for sacroiliac joint dysfunction is usually non-surgical and focuses on restoring normal motion in the joint and for this you will usually be in the hands of an osteopath or physio. Sacroiliac joint fusion is available for severe, debilitating SI joint dysfunction.
Piriformis syndrome also causes symptoms similar to sciatica. It occurs when the piriformis muscle in the buttocks irritates the sciatic nerve, which can cause pain to radiate along the path of the nerve into your leg. In some people the sciatic nerve goes behind the piriformis muscle in some people it goes in front of the muscle but in 17% of the population it actually goes through the muscle and tightness in this muscle will give sciatic like symptoms.
WHY IT IS IMPORTANT TO GET A PROPER DIAGNOSIS.
There are other serious conditions that could give the symptoms of sciatica that need immediate treatment.
Cordai equani syndrome – this can effect bladder and bowel function and is a medical emergency. Infections of the spine and rare though it is a spinal tumour. These are rare but it is important to get a proper diagnosis to rule them out.
TREATMENT: Treatment is determined by the diagnosis.
Once you have been given the proper diagnosis and treated as necessary you should be given clearance to exercise.
You need to get advice on the correct exercises to do and get your technique checked. Consistency is important.
I work predominantly with two osteopaths Sam McInerney (www.osteocrawley.co.uk) who also works out of her clinics in Crawley and Lancingand David Such (www.davidsuch.com) who works at K2 in Crawley. We have two way lines of communication and where necessary give me guidance as the ongoing treatment that they want. If you see other osteopaths and you want them to contact me, I’m happy to do so. Whoever you see you will need to give them your consent to discuss you – patient confidentially etc..