The sciatic nerve is the longest and largest of all the body’s nerves. It runs from the spinal column through the pelvis and down each leg. Each sciatic nerve is made up of five smaller nerves that branch into the thigh, knee, calf, ankle, and foot. Sciatica occurs when this nerve is compressed, irritated, or inflamed.
Sciatica is not a condition or a diagnosis, rather it is a term used to describe the symptoms of leg pain and possibly tingling, numbness or weakness that travels from the low back through the buttock and down the large sciatic nerve in the back of the leg. The pain may be anything from a dull ache to a sharp, burning sensation or excruciating discomfort. Sometimes it may feel like a jolt or electric shock.
Because the sciatic nerve is the longest nerve in the body, pressure can be placed on it at many locations. Disc bulges can place pressure on the sciatic nerve in the back and cause low back pain and sciatica. The piriformis muscle, located deep in the buttocks, can become too tight and put pressure on the sciatic nerve. Pressure from the piriformis muscle usually causes sciatica that starts in the buttock or upper thigh. A misalignment of the lumbar vertebrae in the low back can put pressure on the sciatic nerve. Finally, spinal degeneration from long-standing back problems can also put pressure on and irritate the sciatic nerve.
How can Osteopathy help?
Since there are many disorders that can cause Sciatica, an Osteopath will investigate the exact cause of sciatic nerve symptoms by taking a thorough case history, followed by relevant spinal, orthopaedic and neurological examination to establish an accurate diagnoses. Referral for diagnostic imaging such as X-ray, CT or MRI may be necessary.
As Sciatica is due to pressure on the sciatic nerve, treatment involves removing this pressure, in order to reduce symptoms and help resolve the problem. Osteopathic treatment aims to decrease nerve pressure and associated inflammation by focusing treatment on poorly moving spinal joints, body compensatory patterns and easing muscular tension in the spine, buttock, hip and leg. Osteopathic techniques and management strategies are dependent on each individual case.
Low back pain causes more disability than nearly 300 other conditions worldwide, according to new research, and nearly one in 10 people across the globe suffers from an aching lower back.
A second study, which looked at the condition in specific types of jobs, found that low back pain is responsible for about a third of work-related disability.
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OSTEOPATHIC PRINCIPLES IN MANAGING BACK PAIN
These are an integral part of the overall evaluation and management of every patient.
The body is a unit. As the osteopath approaches the diagnosis of the patient’s condition, the unity of the body should be kept in mind. It is never good practice to isolate the focus of the examination to a single body part, even though the symptom may seem related to only one area. A clear example is lower back pain. Pain in the lower back may be predisposed to or maintained by flat feet, dysfunction of the knee or hip, sacro-iliac joint dysfunction, pelvic imbalance, muscle imbalances anywhere in the body, or restrictions of the upper back, essentially postural imbalance that has caused compensation from the feet to the head. The osteopath must consider all facets of interrelatedness of the body.
Structure and function are interrelated. The osteopath must recognise that an abnormal structure is likely to result in abnormal functioning of that body part. Likewise, longstanding abnormal function will eventually affect the structure involved by creating a compensatory position or motion pattern, changes in the structure itself, or stresses on the structure that will result in a breakdown of tissue. A treatment plan must focus on improving the structure and function of the patient to the nearest normal possible for that patient, even when those restrictions found do not seem to be related to the problem at hand. The musculoskeletal system is the osteopath’s route to the treatment of many conditions both of that system and other systems connected to it by the nervous and circulatory systems.
The body is self-regulating and self-healing. The osteopath will use the body’s ability to repair and maintain itself. It is then the role of the osteopath to know when and where to intervene to assist the body in its healing process. Osteopathic considerations in doing so include: (1) Maintaining good circulation to involved body parts. (2) Treating all restrictions that interfere with motion of any body part or mobility of the patient in general. (3) Removing any sources of pain or discomfort that are treatable manually. (4) Preventing dysfunction of spinal segments that may send inappropriate feedback to involved structures through the nervous system.