SCIATICA

Written by Dr. Alison Gault B. App. Sci. (clinical sci) B. Osteo. Sci.  from Vale Osteopathy Clinic located in Ascot Vale and 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 arises as many little nerves from spinal cord in the lumbar spine (lower back).  The little nerves then pass out of the spinal canal between the vertebrae, pass through the pelvis 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

I will be covering this topic further in the next newsletter as it is a big topic.  As I mentioned previously, the sciatic nerve, as it comes out of the spinal cord, passes between the vertebrae. The disc is like a shock absorber between two vertebrae.  The disc can bulge and press upon one of the little nerves as it comes out of the spine.  This can be quite a serious condition causing severe pain, numbness, tingling and weakness in the legs.  Thankfully, I don’t often see this condition.

Pregnancy

In the late 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 vertebrae.  These bone growths can press on a little nerve as it comes out of the vertebrae, therefore causing the sciatica symptoms.

Here are some causes of Pseudo-sciatica. This is a condition that can have the 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.  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 sciatica like symptoms are most commonly found in the ‘glute’ (bum) muscles or the deep hip muscles.

Sacroilliac joint dysfunction

The sacroiliac joints are the two large joints at the back of the pelvis.  These quite commonly become inflamed or irritated and may cause referred pain in the legs. This however is more commonly down the side of the thigh than the back of the thigh.

So what can you do about it???

• Always sit with good posture and both your feet on the ground.
• Never, never sit with your wallet in your back pocket, you are just asking for piriformis syndrome!
• Lift properly. This means using you 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 not to put extra pressure onto your discs and pelvic joints.
• Get treatment and advice. Osteopathic treatment can assist will all the causes of sciatica and pseudo-sciatica explained above.

Disclaimer: information provided on this post is of a general nature and should not be used in place of advice from either myself or another medical  professional

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

Tags: arthritis, Back Pain, disc bulge, disc prolapse, piriformis syndrome, Pregnancy, sciatica, treatment, trigger points