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Sciatica

see a lot of patients that believe they have sciatica – We are going to explain a bit about what sciatica really is, what else it might be, what we can do to help and how you can help yourself


Firstly, the sciatic nerve is the longest and thickest nerve in the body, at its widest point the sciatic nerve is as thick as an adult’s thumb. It stems from the lower back, moves through the buttocks, back of the thigh; then branches into the leg and foot.

When the sciatic nerve becomes irritated or compressed by structures within the lower back, pelvis or buttock area it can cause symptoms such as:

· Sharp electric, stabbing or burning pain; which can occur in the buttocks, back of the legs, feet and/or toes.

· This can be accompanied with numbness and/or pins and needles within these same areas


Although the sciatic nerve passes through the gluteal (buttock) region, it does not control any muscles there. However, the sciatic nerve does directly innervate the muscles in the back of the thigh which, if compromised may cause:


· a limp

· Weak leg muscles.

· Hot or cold sensations in the leg.

· Symptoms can often be exacerbated by bending forward, twisting and coughing or sneezing.

Causes of sciatica:

Herniated or prolapsed disc – when the soft cushion of tissue between the bones in your spine pushes out, compressing the sciatic nerve.


Spinal stenosis – When areas within the spine become narrower causing compression of the sciatic nerve



Piriformis syndrome – Compression of the sciatic nerve by the piriformis muscle located in buttocks.


Inflammation irritating the nerve – Following an injury or infection.


You are at a greater risk of developing sciatica if you are tall, overweight and with advancing age.



WARNING!

Symptoms similar to sciatica can be a sign of a serious condition ‘Cauda Equina’. The NHS recommend you dial 999 or go to A&E if you:

· Have the above symptoms of sciatica on both sides.

· Have severe weakness or numbness in both legs that is getting worse.

· Have numbness around your genital/saddle area.

· Have any abnormal changes to your bowel or bladder habits such as difficulty starting urination or loss of bladder/bowel control (incontinence).

What other conditions can cause these symptoms?

Sacroiliac joint dysfunction - Pain from the sacroiliac joint can occur in similar areas as sciatica; in the lower back, buttocks and thigh.

Lumbar spine Facet joint irritation – where the little joints in the lower spine get irritated, causing local and radiating pain in the back, hip and thigh.



Hip conditions such as the early stages of osteoarthritis and hip bursitis can cause pain in similar to when the sciatic nerve is irritated.


How can we help you if you have ‘sciatica’ type symptoms?

As osteopaths we have been trained to differentiate between conditions that can cause similar symptoms. This can be achieved by gathering information regarding your medical history, symptoms, observing the way you move and by conducting orthopaedic tests. This process allows us to diagnose and treat the cause of your pain and not just the symptoms.


How can you help yourself?

Walking, swimming and yoga can really help and there are specific stretches that can target the areas I’ve just discussed.


Knee hugs can be very beneficial:

Lie on your back on a mat or the carpet, this can even be done in bed… bend your knees and have them hip-width apart. Keep your upper body relaxed and your chin slightly tucked in. Bend one knee up towards your chest and hold it with both hands. Hold for 20 to 30 seconds with controlled deep breaths. Repeat a few times, alternating legs. Or you can do both knees together. Only stretch as far as is comfortable for you.



Lying or standing hamstring stretches – hug one knee into your body as described before, holding the back of the thigh and slowly straighten the knee until you can feel a good stretch from the back of the knee towards the buttock area. Standing, raise one leg onto a stable object, such as a step, push the buttocks backward and with a straight back lean forward only as far as is comfortable – again hold for 20-30 seconds and repeat a few times


Sitting or lying gluteal stretch, cross one ankle over the opposite knee – make sure the ankle is well supported – aim the top leg away from your body. If you can you may want to lift the standing leg up and hug that into the body to increase the stretch and by tilting the lower body a little you will find the best stretch for you – as before hold this for 20-30 seconds, repeat both sides a few times.


Keeping the hips and lower back mobile with some pelvic tilts can also really help – Standing - imagine the pelvis is like a bowl of water and you want to tip the water out of the front, then the back and likewise, side to side too.


We are here if you need some help so please don’t suffer with these symptoms unnecessarily.


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