Dr Jessica Sammut
What is Sciatica?
Sciatica is characterised by pain travelling into the buttocks, hip, leg and or foot, as a result of nerve irritation or compression in the back or buttock. Sciatica can be described as a dull ache, a shooting pain, numbness, tingling or pins and needles. Most people will be experiencing back pain at the same time as they are feeling sciatica but this is not always the case and there are a wide range of causes. Some people will have a memorable onset for their sciatica such as a twisting and lifting injury whereas others may feel pain coming on gradually over a period of time.
The sciatic nerve is formed from a bundle of nerves that exit between the lower vertebrae in the spine and pelvis. The bundle of nerves merge together to form one big sciatic nerve that then runs down into the leg. The role of the sciatic nerve is to supply specific areas of the leg with sensation and provide power to certain muscles in the leg. This explains why when the sciatic nerve is compressed or irritated it affects the function and feeling in the leg.
Diagnosis & Treatment for Sciatica
Osteopaths are highly trained to diagnose and treat sciatica, and this is important because sciatica is traditionally over-diagnosed.
First of all we are able to carry out a neurological examination to check how the sciatic nerve is functioning. Further examination into the spine and legs will allow the Osteopath to gain more insight into what is causing the pain. This then will allow us to diagnose whether you are experiencing true sciatic nerve irritation or something else which can mimic Sciatica. Many people think they have sciatica but in fact there is another reason for their pain which can be relieved easily with Osteopathic treatment.
Osteopathic treatment for sciatica will involve freeing the back and sciatic nerve along its pathway from the spine into the leg. This may be done with spinal manipulation, soft tissue release, dry-needling and exercise. Depending on what is causing your Sciatica will depend on how long it will take you to recover. Once your Osteopath has completed their assessment they will be able to give you an idea of your prognosis and recovery.
“Trapped Nerves” - Common misconception!
Many patients think a nerve might be ‘trapped’ in their body as they have one or a combination of many symptoms including pain, pins and needles, tingling, numbness or even weakness into a particular area of your body. The term “trapped nerve” is not an accurate diagnosis because nerves cannot become trapped. However they can be compressed and irritated by parts of your body which can then Injure the nerve and cause it to become inflamed and then symptomatic.
Here is a little bit of anatomy to explain further.
From your spinal cord there are nerves that exit between the vertebrae. These nerves travel around your body, down into your legs and arms. Each nerve has its own role, for example, to supply sensation to a specific area of skin (called a dermatome) or to supply a particular muscle (called a myotome). The area that you are experiencing pain or altered sensation in, will indicate which nerve has become irritated. For example, symptoms into the thumb, index and middle finger of the hand indicate the median nerve is being irritated because that nerve supplies the sensation to those digits. This is also known as carpal tunnel syndrome. Another common “trapped nerve” is when the Sciatic nerve is injured, this will then give you Sciatica (pain or altered sensation into the back of the leg).
Diagnosis & Treatment of Irritated Nerves
Osteopaths are highly trained to diagnose and treat nerve compression and nerve irritations. They can carry out neurological examinations to test the nerves in the body. This means from the symptoms that are described and the tests carried out they can diagnose many nerve injuries. Treatment will then involve reducing the irritation to the nerve along its pathway. This may mean manipulating the spine or other joints in the body, releasing tight muscles and prescribing specific exercises.
Recovery time for nerve pain and nerve injuries will vary greatly depending on what is causing the nerve compression. Your Osteopath will be able to give you an idea of your prognosis after their assessment