Sciatica is a condition characterized by pain that travels along the path of the sciatic nerve. This nerve extends from the lower back, through the hips and buttocks, and down each leg.

Causes: Sciatica most commonly arises when a herniated disk or the growth of bone, known as bone spurs, puts pressure on a portion of the sciatic nerve. This pressure results in inflammation, pain, and often numbness in the affected leg. In rarer cases, a tumor pressing on the nerve or nerve damage caused by a condition like diabetes can also lead to sciatica.

Symptoms: The pain associated with sciatica can occur at various points along the nerve pathway, but it often follows a course from the lower back to the buttock, and down the back of the thigh and calf. The pain can range from a mild ache to a sharp, burning sensation and may sometimes feel like a jolt or electric shock. It can worsen during activities like coughing, sneezing, or prolonged sitting. Typically, sciatica affects only one side of the body. Additional symptoms may include numbness, tingling, or muscle weakness in the leg or foot, with different areas of the leg experiencing pain and numbness.

When to See a Doctor: Mild sciatica often resolves with time and self-care. However, it’s essential to contact your primary care provider if self-care measures don’t alleviate symptoms or if the pain persists beyond a week, becomes severe, or worsens. Seek immediate medical attention for:

  • Sudden, severe pain in the lower back or a leg accompanied by numbness or muscle weakness in the leg.

  • Pain following a traumatic injury, such as a traffic accident.

  • Difficulty controlling bowel or bladder functions.

Risk Factors: Several factors increase the risk of developing sciatica, including:

  • Age: Age-related changes in the spine, such as herniated disks and bone spurs, are the most common causes of sciatica.

  • Obesity: Excess weight places additional stress on the spine.

  • Occupation: Jobs involving back twisting, heavy lifting, or prolonged periods of driving can contribute to sciatica.

  • Prolonged sitting: Inactivity and extended periods of sitting are associated with a higher risk of developing sciatica.

  • Diabetes: This condition, affecting blood sugar regulation, can raise the risk of nerve damage, including sciatic nerve issues.

Complications: While most people recover fully from sciatica, there can be nerve damage in severe cases. Seek immediate medical attention if you experience:

  • Loss of feeling in the affected leg.
  • Weakness in the affected leg.
  • Loss of bowel or bladder control.

Prevention: Preventing sciatica isn’t always possible, and the condition may recur. However, some measures can help protect the back:

  • Regular exercise: Strengthen the core muscles (abdominal and lower back) to maintain good posture and alignment. A healthcare provider can recommend suitable activities.
  • Proper sitting posture: Use a chair with good lower back support, armrests, and a swivel base. Adding a pillow or rolled towel in the small of the back can provide better support. Keep knees and hips level.
  • Correct body mechanics: When standing for extended periods, occasionally rest one foot on a stool or small box. When lifting heavy objects, use your legs, keep the load close to your body, and avoid lifting and twisting simultaneously. Seek assistance when handling heavy or awkward items.

How Osteopathy and Physiotherapy Can Help with Sciatica:

Osteopathy: Osteopathy is a holistic healthcare approach that focuses on the musculoskeletal system and its impact on overall well-being. Osteopathic treatment for sciatica includes:

  • Manual Therapy: Osteopaths use hands-on techniques like joint manipulation to align the spine and pelvis, reducing pressure on the sciatic nerve and relieving pain.
  • Soft Tissue Manipulation: Osteopaths use techniques like massage to relax muscles, reducing tension and improving flexibility.
  • Postural Assessment: Osteopaths analyze posture and movement patterns to identify factors contributing to sciatica and offer guidance on ergonomics and exercises.
  • Exercise Prescription: Osteopaths recommend tailored exercises to strengthen the core and support the lower back, preventing future sciatica episodes.
  • Lifestyle Advice: Osteopaths provide guidance on lifestyle changes, nutrition, and stress management to enhance overall health and minimize sciatica triggers.

Physiotherapy: Physiotherapy focuses on restoring and maintaining physical function, and it can help with sciatica in these ways:

  • Customized Exercise Programs: Physiotherapists design personalized exercise routines to enhance core strength, flexibility, and posture, reducing sciatic nerve pressure.
  • Manual Techniques: Physiotherapists use hands-on methods like joint mobilization, stretching, and soft tissue manipulation to ease pain and improve mobility.
  • Electrotherapy: Modalities like ultrasound, TENS, and heat/cold therapy are used to alleviate pain and inflammation.
  • Education: Physiotherapists educate patients on proper body mechanics, posture, and ergonomics to prevent future sciatica episodes.
  • Functional Rehabilitation: In severe cases, physiotherapy helps patients regain strength and movement through targeted exercises and rehabilitation.
  • Pain Management: Physiotherapists may use pain relief techniques like acupuncture or dry needling for sciatic pain.

Both osteopathy and physiotherapy are valuable for managing sciatica by addressing its causes, alleviating symptoms, and restoring function. The choice between these approaches depends on individual preferences, condition severity, and professional recommendations. Consult a qualified practitioner to determine the best treatment plan for your specific case.

Vaughan Woodbridge

Andrew Chan, R.H.N., DOMP, B.Sc., DO (Euro)

Ankit Patel, H.BscKin, MPT, MCPA

Seong Eun (Tina) Ra,
R. Ac

Daniel Galano,

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