Sciatica

What is sciatica?

Sciatica is a term used to describe a set of symptoms that result from irritation or compression of the sciatic nerve, which is the longest nerve in the body and runs from the lower back, through the hips and down the legs. Symptoms can include lower back pain, pain or numbness in the legs, and weakness in the muscles of the legs.

Sciatica in itself is not a diagnosis, but rather an indication that something is compressing or irritating the sciatic nerve.

The underlying cause of sciatica can vary widely, and can include conditions such as a herniated disc, degenerative disc disease, spinal stenosis, and lumbar spinal arthritis, among others. Each of these conditions can cause pressure on the sciatic nerve, leading to the symptoms of sciatica.

For this reason, sciatica is considered a symptom rather than a diagnosis, and it’s important to undergo a thorough evaluation by a medical professional in order to determine the underlying cause of the symptoms. Only after the underlying cause is determined can an accurate diagnosis be made and appropriate treatment be prescribed.

 

What does sciatica feel like?

Sciatica can cause a variety of symptoms, but most commonly it is described as a sharp, burning pain or a dull, aching sensation that radiates from the lower back down the back of one leg. Some people may also experience tingling, numbness, or weakness in the affected leg. The intensity of the pain can range from mild to severe and can be exacerbated by activities such as sitting, standing, or bending.

Does sciatica go away on its own?

In some cases, sciatica may resolve on its own without the need for medical intervention. This can happen if the underlying cause of the sciatica, such as a herniated disk, resolves or heals on its own. However, in many cases, sciatica does not go away on its own and requires treatment in order to manage symptoms and prevent them from worsening over time.

Treatment options can include osteopathy, physiotherapy, pain medication, and in some cases, surgery.

If you’re experiencing symptoms of sciatica, it’s important to determine the underlying cause and the best course of treatment.

What triggers sciatica?

Sciatica is typically caused by a compressed or irritated sciatic nerve. This can be triggered by a number of underlying conditions, including:

Herniated disc: A herniated disk, also known as a slipped disc, occurs when the soft centre of a disc bulges out and presses against the sciatic nerve.

Degenerative disc disease: As people age, the discs in their spine can become dry and brittle, leading to cracks and wear and tear that can compress the sciatic nerve.

Spinal stenosis: This condition occurs when the spinal canal narrows and compresses the nerve roots, including the sciatic nerve.

Spinal tumours: Tumours growing in the spinal column can put pressure on the sciatic nerve.

Piriformis syndrome: This condition occurs when the piriformis muscle, which runs from the lower spine to the hip, compresses the sciatic nerve.

Pregnancy: During pregnancy, the weight gain and hormonal changes can lead to a shift in the spine, causing compression of the sciatic nerve.

It’s important to note that sciatica can have more than one underlying cause, and multiple factors can contribute to its development. If you’re experiencing symptoms of sciatica, it’s important to see a osteopath or doctor to determine the cause and the best course of treatment.

What aggravates sciatica?

Sciatica can be aggravated by a number of factors, including:

Prolonged sitting: Sitting for extended periods of time can put pressure on the sciatic nerve, worsening symptoms.

Bending and twisting: Bending or twisting the lower back, especially while lifting heavy objects, can irritate the sciatic nerve.

Inactivity: Lack of physical activity can cause the muscles that support the lower back to weaken, increasing the risk of sciatica.

Overuse: Engaging in repetitive motions or overusing the lower back can lead to inflammation and compression of the sciatic nerve.

Poor posture: Maintaining poor posture, such as slouching or hunching over, can put strain on the lower back and increase the risk of sciatica.

It’s important to avoid or minimize activities and movements that may worsen your symptoms, and to talk to your osteopath about which exercises or treatments may help alleviate your sciatica.

What are red flags for sciatica?

Red flags for sciatica are symptoms or risk factors that suggest a more serious underlying condition that requires prompt medical attention. Some red flags for sciatica include:

Progressive weakness in the legs: If you’re experiencing increasing weakness in the legs, it could be a sign of a more serious underlying condition, such as a spinal cord compression.

Loss of bladder or bowel control: If you’re experiencing loss of bladder or bowel control, it could be a sign of a serious condition, such as cauda equina syndrome, and requires immediate medical attention.

Severe pain: If you’re experiencing sudden and severe pain, it could be a sign of a more serious underlying condition, such as a herniated disc, that requires prompt medical attention.

Unusual symptoms: If you’re experiencing unusual symptoms, such as fever, unexplained weight loss, or a rash, it could indicate an underlying infection or systemic disease that requires medical attention.

Previous history of cancer: If you have a previous history of cancer, the pain could be a symptom of a new cancerous growth that is pressing on the sciatic nerve.

If you’re experiencing any of these red flags, it’s important to see a doctor as soon as possible to determine the underlying cause and the best course of treatment.

What is the best sleeping position for sciatica?

The best sleeping position for sciatica can vary depending on the individual and the underlying cause of the sciatica. However, some general tips for sleeping with sciatica include:

Sleeping on your back: Sleeping on your back with a pillow under your knees can help reduce the pressure on your lower back and relieve sciatica pain.

Sleeping on your side: If you prefer sleeping on your side, it’s important to place a pillow between your legs to maintain the natural alignment of your spine.

Sleeping on your stomach: Sleeping on your stomach is generally not recommended as it can put additional pressure on the lower back and worsen sciatica pain.

It’s also important to use a supportive mattress that helps maintain the natural alignment of your spine. If you have trouble sleeping or if your pain is affecting your sleep, it’s important to talk to your osteopath/doctor about the best treatment options for your specific case.

Will walking help sciatica?

Walking can be an effective form of exercise for some people with sciatica, as it can help to increase circulation, relieve muscle tension, and reduce pressure on the sciatic nerve. However, it’s important to talk to your osteopath/doctor before starting any new exercise routine, especially if you’re experiencing severe pain. Your osteopath can help determine the best course of action and the types of exercises that are safe and effective for you.

In general, low-impact exercises, such as walking, swimming, or cycling, are recommended for people with sciatica as they can help improve mobility and strengthen the muscles that support the lower back without putting additional strain on the affected area. Stretching and strengthening exercises, such as yoga or Pilates, can also help alleviate sciatica pain by improving flexibility and reducing muscle tension.

It’s important to listen to your body and avoid activities that worsen your pain.

What should you not do with sciatica?

People with sciatica should avoid certain activities or movements that can worsen their symptoms and cause further irritation to the sciatic nerve. Some activities to avoid with sciatica include:

Prolonged sitting: Sitting for extended periods of time can put pressure on the sciatic nerve, worsening symptoms.

Bending and twisting: Bending or twisting the lower back, especially while lifting heavy objects, can irritate the sciatic nerve.

Heavy lifting: Lifting heavy objects can put additional strain on the lower back and worsen sciatica pain.

Repetitive motions: Engaging in repetitive motions, such as running or jumping, can lead to inflammation and compression of the sciatic nerve.

Poor posture: Maintaining poor posture, such as slouching or hunching over, can put strain on the lower back and increase the risk of sciatica.

When should I see a doctor for sciatica?

You should see a doctor for sciatica if you experience any of the following symptoms:

Persistent pain: If you have been experiencing pain for more than a few days or if the pain is severe, it’s important to see a doctor to determine the underlying cause and the best course of treatment.

Numbness or tingling: If you’re experiencing numbness or tingling in your leg or foot, it could be a sign of nerve compression and it’s important to see a doctor to rule out any underlying conditions.

Weakness or difficulty moving: If you’re experiencing weakness or difficulty moving your leg or foot, it could be a sign of nerve compression and it’s important to rule out any underlying conditions.

Red flags: If you’re experiencing any red flags, such as progressive weakness, loss of bladder or bowel control, severe pain, or unusual symptoms, it’s important to see a doctor as soon as possible to rule out a more serious underlying condition.

How long does it take for sciatica to go away?

The length of time it takes for sciatica to go away can vary depending on several factors, such as the underlying cause of the sciatica, the severity of the symptoms, and the individual’s response to treatment.

For some people, sciatica can go away on its own within a few days or weeks with rest, pain management, and exercise. For others, the symptoms can persist for several months or even years, and may require more aggressive treatment, such as surgery.

What are the 4 types of sciatic irritation?

There are several types of sciatica that can be classified based on the underlying cause of the sciatic nerve compression. Some of the most common types of sciatica include:

Herniated disk: This is the most common cause of sciatica and occurs when a disk in the lower back ruptures and presses on the sciatic nerve.

Degenerative disk disease: This occurs when the disks in the lower back become thin and worn, leading to compression of the sciatic nerve.

Spinal stenosis: This occurs when the spinal canal narrows, leading to compression of the sciatic nerve.

Piriformis syndrome: This occurs when the piriformis muscle, located in the buttocks, becomes tight and presses on the sciatic nerve.

It’s important to note that there are several other causes of sciatica and that the specific type of sciatica that a person experiences will depend on the underlying cause of their symptoms. Your osteopath can help you determine the underlying cause of your sciatica and the best course of treatment for your specific case.

How does a doctor treat sciatica?

Treatment for sciatica depends on the underlying cause of the symptoms, the severity of the pain, and the individual’s response to treatment. Some common treatments for sciatica include:

Pain management: Pain management can help to alleviate the pain and discomfort associated with sciatica. This may include over-the-counter pain medication, such as ibuprofen, or prescription pain medication, such as muscle relaxants or opioids.

Exercise: exercise can help to strengthen the muscles in the back and reduce the pressure on the sciatic nerve. This may include exercises to improve posture and flexibility, as well as manual therapy to relieve tension in the muscles and improve range of motion.

Epidural injections: Epidural injections can help to reduce inflammation and alleviate pain by injecting a corticosteroid medication into the epidural space.

Surgery: In some cases, surgery may be necessary to alleviate symptoms. This may include microdiscectomy, laminectomy, or spinal fusion.

It’s important to work with your doctor and osteopath/physio to determine the best course of treatment for your specific case. In some cases, a combination of treatments may be necessary to achieve optimal results.

What is the straight leg test for sciatica?

The straight leg raise test, also known as the Lasègue sign, is a simple test that is often used to diagnose sciatica. The test is performed by lying down on your back and raising one leg straight up into the air while keeping the other leg flat on the ground. The test is considered positive if raising the leg causes pain in the lower back, buttocks, or leg, and is typically indicative of sciatica.

The straight leg raise test helps to determine whether the sciatic nerve is being compressed, as this test puts tension on the sciatic nerve and can cause pain if the nerve is being compressed. However, it’s important to note that a positive straight leg raise test is an indicator and does not necessarily mean that a person has sciatica, as there are many other conditions that can cause similar symptoms.

How can you test for sciatica at home?

While at-home tests can help identify symptoms of sciatica, it’s important to work with a osteopath to make a definitive diagnosis and determine the underlying cause of the symptoms. Some common at-home tests for sciatica include:

Straight leg raise test: This test involves lying on your back and raising one leg straight into the air. If raising the leg causes pain in the lower back, buttocks, or leg, it may indicate sciatica.

Slump test: This test involves sitting on the edge of a chair and slumping forward, then slowly standing up. If this test causes pain in the lower back, buttocks, or leg, it may indicate sciatica.

McHenry test: This test involves lying on your back with both legs bent and then slowly extending one leg. If extending the leg causes pain in the lower back, buttocks, or leg, it may indicate sciatica.

It’s important to keep in mind that these tests are not a definitive diagnosis and not a definite diagnosis of sciatica.

How does a GP diagnose sciatica?

A GP (general Practitioner) typically diagnoses sciatica through a combination of a physical examination, medical history, and diagnostic tests.

Physical examination: The GP will examine the patient’s posture, range of motion, and reflexes. They may also perform a straight leg raise test to assess tension on the sciatic nerve.

Medical history: The GP will ask about the patient’s symptoms, including the location and type of pain, as well as when the pain started and any other relevant medical history.

Diagnostic tests: The GP may order imaging tests, such as an MRI or X-ray, to help determine the underlying cause of the symptoms. They may also order nerve conduction studies or electromyography (EMG) tests to assess the health of the sciatic nerve.

Based on the results of the physical examination, medical history, and diagnostic tests, the GP can determine whether the symptoms are indicative of sciatica and make a diagnosis. They may also refer the patient to a specialist, such as an orthopedic surgeon or a neurosurgeon, for further evaluation and treatment.

Does sciatica show up on xray?

An X-ray is generally not an effective test for diagnosing sciatica. X-rays can show the bones in the back and any spinal abnormalities, such as vertebral fractures or tumours, but they do not provide detailed images of soft tissues, such as the discs, nerves, or muscles.

For this reason, other imaging tests, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, are typically used to diagnose sciatica. These tests can provide detailed images of the soft tissues in the back and help to determine the underlying cause of the symptoms.

In some cases, a GP may order an X-ray if they suspect that a spinal abnormality, such as a vertebral fracture or tumour, is causing the symptoms. However, if the X-ray is normal and the symptoms are consistent with sciatica, the GP may order a more specialised imaging test, such as an MRI, to make a definite diagnosis.

Is sciatica permanent?

Sciatica can be a temporary or a permanent condition, depending on the underlying cause and the severity of the symptoms.

In many cases, sciatica can be treated effectively with non-surgical treatments, such as osteopathy, physiotherapy, medications, and exercise. With proper treatment, the symptoms of sciatica can often be relieved within a few weeks to a few months.

However, in some cases, the underlying cause of the sciatica, such as a herniated disc or spinal stenosis, may not be treatable and the symptoms may persist over time. In these cases, the sciatica may be permanent, although the severity of the symptoms may be managed with ongoing treatment and management.

Early treatment is often key to a successful outcome and can help prevent long-term complications or the development of chronic pain. If you have persistent symptoms or if the symptoms worsen over time, it’s important to seek medical attention.

Does sciatica cause hip pain?

Yes, sciatica can cause hip pain. The sciatic nerve is the longest and largest nerve in the body and runs from the lower back down through the legs and feet. When the sciatic nerve is compressed or irritated, it can cause pain, tingling, or numbness in the lower back, buttocks, and legs, as well as in the hips.

Hip pain is a common symptom of sciatica, especially when the pain radiates from the lower back down through the legs and hips. In some cases, the hip pain may be the primary symptom of sciatica, while in other cases, it may be accompanied by lower back pain, leg pain, or other symptoms.

It’s important to seek medical attention if you have persistent hip pain or if the pain worsens over time.

Can sciatica cause bowel problems?

Sciatica can, in rare cases, cause bowel problems. Sciatica is characterized by pain, tingling, or numbness in the lower back, buttocks, and legs that is caused by compression or irritation of the sciatic nerve.

However, in very rare cases, the sciatic nerve may also control the muscles that are responsible for bowel and bladder function, known as the sacral plexus. When the sciatic nerve is compressed or irritated in these cases, it can cause bowel problems, such as constipation, incontinence, or difficulty with bowel movements.

If you have bowel problems along with lower back pain, leg pain, or other symptoms of sciatica, it’s important to seek medical attention.

How do I know if it’s my hip or sciatica?

It can be difficult to distinguish between hip pain and sciatica, as both conditions can cause similar symptoms. However, there are a few key differences that can help you determine the cause of your pain:

Location: Hip pain is typically felt in the front or side of the hip, while sciatica is characterized by pain that radiates from the lower back down through the legs and buttocks.

Aggravating Factors: Sciatica is often worsened by activities that put pressure on the lower back, such as sitting or standing for long periods of time, while hip pain may be worsened by activities that put stress on the hip joint, such as climbing stairs or walking on uneven surfaces.

Other Symptoms: Sciatica may be accompanied by other symptoms, such as lower back pain, tingling or numbness in the legs, or weakness in the legs, while hip pain is usually a standalone symptom.

An osteopath or other professional manual therapist can normally distinguish between sciatica and hip pain.

If you have persistent pain in the hip or lower back, it’s important to seek medical attention.

Can an osteopath help sciatica?

An osteopath may be able to help with sciatica by addressing any underlying structural imbalances that may be contributing to nerve compression or irritation. An osteopath uses manual therapy techniques, such as massage, stretching, and joint mobilization, to improve the function of the muscles and joints, reduce pain and inflammation, and improve range of motion.

While osteopathic treatment may provide relief for some individuals with sciatica, it’s important to keep in mind that it may not be appropriate for everyone. Your doctor can help determine if osteopathic treatment is a good option for you, and if so, they may refer you to an osteopath for treatment.

It’s also important to note that osteopathic treatment should be used in conjunction with other conventional medical treatments for sciatica, such as exercise, pain management, and surgery, if necessary. Osteopathic treatment may help to complement other treatments and provide additional relief from sciatica symptoms.

Do I need a physio or osteopath for sciatica?

Whether you need a physiotherapist or an osteopath for sciatica depends on your specific condition and the underlying cause of your symptoms.

A physiotherapist can help with sciatica by using various techniques, such as exercise therapy, manual therapy, and electrotherapy, to reduce pain, improve mobility, and strengthen the muscles that support the lower back and legs. Physiotherapy can be particularly helpful if your sciatica is caused by poor posture, weakness in the muscles that support the lower back, or other musculoskeletal imbalances.

An osteopath can be helpful for sciatica if the underlying cause of your symptoms is related to structural imbalances in the bones, muscles, and joints. An osteopath can use manual therapy techniques, such as massage, stretching, and joint mobilization, to improve the function of these structures and reduce compression on the sciatic nerve.

In some cases, a combination of physiotherapy and osteopathic treatment may be most effective for managing sciatica symptoms.

 

 

Note:

It is important to note that while osteopathy is an effective therapy and complementary to conventional medical treatments, it should not be used as a substitute for conventional medical care. Osteopaths and GP can work very effectively to create the best possible outcome for you.

This information is intended to provide general information and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the appropriate medical advice from GP or other qualified healthcare provider with any questions you may have regarding a medical condition.

 

More Q & A’s

Osteopathy

Back Pain

Plantar Fasciitis

Orthotics & Insoles