Conditions we treat

If you are struggling with Sciatica symptoms it is important to seek out a registered qualified healthcare professional that can quickly help to give you pain relief.

Osteopaths have the training and expertise to 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. We can usually accommodate more urgent appointments within 24 hours of enquiry.

What is Sciatica?

Sciatica is when the sciatic nerve is irritated. This nerve runs from your spinal cord, through your posterior hip, down the back of the leg, and into the feet. In many cases it usually gets better in 4 to 6 weeks but can last longer. Common causes of sciatica are postural related injuries, or activities such as lifting heavy objects, which can lead to the following:

Inter-vertebral disc bulges or prolapses, usually referred to as slipped discs: this is the most common cause of sciatica. When injured these can press on or irritate the nerves innervating the legs. The discs are essentially cushions used to absorb shock and movement between each bone in the spine. These discs however cannot slip. They are incredibly resilient and surrounded by amazingly strong ligaments connecting them to the spine. They can be injured; however, they do also heal. 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 (bulging) 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

• numbness

• a tingling sensation in one or both legs

Spinal stenosis/Inter-vertebral foraminal stenosis: is a narrowing of the spaces in the spine where the spinal cord, and nerves are located. 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

• infection

• injury

• a growth within the spine, such as a tumor

Spondylolisthesis: when one of the bones in the spine moves out of position, usually due to a fracture.

The piriformis muscle is a deep muscle located in your buttock region, with the sciatic nerve running beneath it. If this muscle is tight, tense, or spasms, it can irritate the sciatic nerve.

If you have Sciatica, you may have symptoms in your buttock/gluteal region, back of the leg(s), feet or toes. These symptoms can include pain (often travelling down the back of the leg), pins and needles or tingling, numbness, weakness, or lower back pain. These symptoms may get worse when moving, leaning forward, sneezing, coughing, straining on the toilet, or slumping in soft chairs. If you are experiencing these symptoms anywhere in the legs (or arms), and not just the areas listed above, it may well be caused by irritation to a nerve other than the sciatic nerve.

If you are experiencing loss of control of your bowel or bladder function, or severe loss of feeling or weakness in the legs, please seek emergency medical attention immediately.

When to seek emergency help

Seek immediate medical help by calling 999 or 112 (from a mobile) 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 can 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

Patients regularly present to osteopaths with symptoms such as sciatica, and in many cases, they can be managed through conservative treatment such as osteopathy. It is first important to diagnose the specific cause of the symptoms so that they may be managed accordingly. Management depends on each individual patient. Once a diagnosis has been made, and you are deemed safe for treatment, a combination of hands on manual treatment, along with specific stretches and exercises to perform at home is usually an effective way to manage the symptoms of sciatica. This may include gentle rhythmical movements of the spine, traction or gapping of the spinal joints, as well as treatment into the hips and upper back, with the aim to decrease the load placed onto the lower back. Medical acupuncture can also be used very effectively if the cause is deemed to be muscular, for example the piriformis muscle as detailed in causes above.

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:

• lumbar decompression – 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 will guide you through the diagnosis and treatment plan to aim to alleviate your sciatic pain. 

For persistent sciatica (known as chronic), you may be advised to try a structured exercise programme under the supervision of your osteopath involving sciatica stretches. Only in very severe cases, surgery may be needed to control the symptoms.

Preventing sciatica

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 your osteopath for advice.