Our osteopaths will be able to give you help and advice if you think you are suffering with sciatica symptoms.
Fast, safe and effective sciatica pain relief is key to allowing individuals suffering with symptoms a speedy recovery. At Chhabra Osteopathy we aim to find you a consultation within 24 hours of your enquiry, at one of our sites in Wimbledon, Woking or Hinchey Wood.
What is Sciatica?
NHS.uk state that Sciatica is the name commonly given to any sort of pain that occurs when pressure is applied to the sciatic nerve causing irritation. This nerve comes from the lower back and supplies impulses to the leg. Damage to the Sciatic nerve may result in changes to sensation or weakness in muscle groups. Accurate and early diagnosis of sciatica is imperative for the best prognosis.
The sciatic nerve is the longest nerve in your body. It runs from the back of your pelvis, through your buttocks, and all the way down both legs, ending at your feet.
When something compresses or irritates the sciatic nerve, it can cause a pain that radiates out from your lower back and travels down your leg to your calf. Sciatic pain can range from being mild to very painful.
Symptoms of sciatica
Sciatica is different to general lower back pain. The pain of sciatica may not affect the back at all but usually radiates out from the lower back, down the buttocks and into one or both of the legs, right down to the calf.
The pain often gets worse over time and may also be made worse by:
• sneezing, coughing or laughing (impulse pain)
• standing or sitting for a long period of time
• bending backwards
If you have sciatica, you may also experience the following symptoms around your legs and feet:
• muscle weakness
• loss of tendon reflexes
Causes of sciatica
These can be variable, but nhs.uk suggest that a slipped disc is the most common identified cause of sciatica, but in some cases there is no obvious cause. It may be tight muscle tissue causing compression of the nerve at some point along its course, causing symptoms.
Less common causes include spinal stenosis (narrowing of the nerve passages in the spine), injury, infection or a growth in the spine. Also it is not uncommon for some women to experience sciatica in pregnancy. See our page on pregnancy related pain for more information.
Most people find their sciatic pain goes away naturally within a few days or weeks. However, see your osteopath or GP if:
• you experience any other symptoms together with your back and leg pain, such as weight loss or loss of bladder or bowel control
• you experience increasingly more pain and discomfort
• your pain is too severe to manage with self-help measures
Slipped discs are most common in people who are between the ages of 30 and 50 years old. The condition affects twice as many men as women. Slipped discs often occur in the lower back. Although around a third of adults in the UK have lower back pain, less than 1 in 20 people have a slipped disc.
A slipped disc, also known as a prolapsed or herniated disc, is where one of the discs in the spine ruptures and the gel inside leaks out.
If pressure is placed on the sciatic nerve it can cause:
• a lasting, aching pain
• a tingling sensation in one or both legs
Spinal stenosis is the narrowing of nerve passages in the spine. It occurs when the bones, ligaments or discs of the spine squash the nerves of the spine (usually the sciatic nerve) causing pain, usually in the lower back and legs. It mainly affects people in their late middle age and older.
Causes of spinal stenosis include:
• age-related changes in the spine
• changes in the ligaments of the spine
• diseases of the bone, such as Paget’s disease
• a growth within the spine, such as a tumour
When to seek emergency help
Seek immediate medical help by calling 999 for an ambulance if you experience the following symptoms:
• numbness in your bottom, lower back and leg
• loss of bladder and/or bowel control
• feeling of weakness in your leg and foot
These symptoms may be signs of a rare condition known as cauda equina syndrome.
Diagnosis of Sciatica
We diagnose a slipped disc from your symptoms and medical history. They may also carry out a physical examination to test:
• reflexes and straight leg raising test
• muscle strength
• walking ability
• sensation in your limbs
Depending on your symptoms, it may be necessary to have further tests, including:
• a blood test to rule out infections
• an x-ray
• imaging tests such as a CT or MRI scan
Treatment of Sciatica
It can take about four to six weeks to recover from a slipped disc (the most common cause of sciatica). Treatment usually involves a combination of physical therapy such as Osteopathy, involving specific exercises for sciatica, massage, manipulation, and sometimes medication to relieve the pain.
Surgery to release the compressed nerve and remove part of the disc may be considered (in severe cases), or if the pain continues for longer than six weeks. Surgical options include:
• discectomy – where the part of the herniated disc pressing on your nerve is removed (this is the most common type of surgery required)
• fusion surgery – if a vertebra has slipped out of place, it may be possible to fuse it into place using a bone graft supported by metal rods
• laminectomy – a procedure often used to treat spinal stenosis, this removes or trims the arch of a vertebra to relieve the pressure on the nerves
However, in many cases, a slipped disc will eventually shrink back away from the nerve, and the pain will ease as the disc stops pressing on the affected nerve.
If you have a slipped disc, it is very important to keep active. Initially, moving may be difficult but after resting for a few days you should start to move around. This will help keep your back mobile and speed up your recovery.
Any exercise you do should be gentle and not put a strain on your back. Swimming is ideal because the water supports your weight and little strain is placed on your joints.
Your osteopath at Chhabra Osteopathy will guide you through the diagnosis and treatment plan to aim to alleviate your sciatic pain. We use our 6 step plan to minimise your discomfort.
For persistent sciatica (known as chronic), you may be advised to try a structured exercise programme under the supervision of a manual therapist such as an osteopath involving sciatica stretches. Only in very severe cases, surgery may be needed to control the symptoms.
There are some steps you can take to minimise your risk of a slipped disc or back injury that could lead to sciatica. This includes:
• better posture and lifting techniques at work
• stretching before and after exercise
• simple, regular sciatica exercises to improve flexibility
Just ask our team of osteopaths for their advice.