Sciatica

Sciatica is a painful syndrome caused by compression or irritation of the sciatic nerve. The sciatic nerve runs deep through the buttock and down the leg. Sciatica can range from a dull ache to an incapacitating pain. It can often resolve quickly with the appropriate management and self-care. However, if it is not adequately followed up, it can become a debilitating condition. Sciatica can be caused by a number of conditions including:

  • bulging/prolapse disc in the lower back
  • bony growths in the lumbar spine
  • arthritis in the low back or hip
  • tight muscles in the buttock
  • fall or other twisting trauma to the lower back
  • pregnancy, due to changes in the pelvis and lower back.

Symptoms include pain in the buttock or down the leg, some pins/needles/numbness down the thigh/leg, difficulty walking or less muscular control of the leg.

Osteopathic treatment is aimed at normalising movement throughout the pelvis, lower back and leg as well as decreasing the muscular tension in the lumbo-pelvic region. Having a more mobile lower back improves the blood flow to the area which assist in decreasing inflammation.

We may also recommend some self-care at home to help manage the pain, this will involve:

  • Start a low impact exercise such as swimming, yoga and pilates to increase flexibility and back strength
  • Sit and stand with good posture
  • Avoid bending and twisting at the same time
  • Use ergonomic furniture such as chairs with lumbar support
  • Use of heat pack or epsom salt baths

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Research:

Burton, K. , Tillotson M. K., Cleary J

Published in Eur Spine J (2000) 9 : 202–207

This single-blind randomised clinical trial compared osteopathic manipulative treatment with chemonucleolysis (used as a control of known efficacy) for symptomatic lumbar disc herniation. By 12 months, there was no statistically significant difference in outcome between the treatments, but manipulation produced a statistically significant greater improvement for back pain and disability in the first few weeks. A similar number from both groups required additional orthopaedic intervention; there were no serious complications. Crude cost analysis suggested an overall financial advantage from manipulation. Because osteopathic manipulation produced a 12month outcome that was equivalent to chemonucleolysis, it can be considered as an option for the treatment of symptomatic lumbar disc herniation, at least in the absence of clear indications for surgery. Further study into the value of manipulation at a more acute stage is warranted.