(Aether Bios Clinic) Bridgeford’s Best Bites: Osteopathy Tips
Sciatica is a common and often debilitating type of pain caused by compression or irritation of the sciatic nerve. There are several causes of this irritation, each causing a variety of symptoms and a different severity of pain; each of these causes may require a different type of handling, treatment and exercises. Have you ever had sciatica? You will know how painful and all-consuming it can be!
The sciatic nerve is the largest nerve in the body, being almost as thick as your little finger; going from the pelvis, through the buttocks, down the legs to the feet. There are two, each exiting either side of the spine between the 4th and 5th lumbar vertebrae just above the pelvis, joining with branches from the 1st – 3rd sacral segments, the triangular bone in the pelvis at the base of the spine. After leaving the pelvis it passes through the buttocks and travels down the back of the leg to the knee where it divides into 2 branches; the tibial nerve that travels down the back of the calf to the foot and the common peroneal nerve that travels down the front and side of the calf into the foot.
Muscles that receive motor input, i.e. about how to work, from the sciatic nerve are in the posterior thigh; the hamstrings and hamstring portion of the adductors. Divisions of the nerve indirectly innervate all the muscles of the leg and foot. The sciatic nerve passes under the piriformis muscle and rarely through it!
Skin receiving indirect sensory (feeling) innervation is the back and side of the leg, the side, sole and top of the foot.
Common Symptoms are pain, burning, tingling or numbness radiating down the leg or foot. Pain can also be from tight tense muscles that are part of the symptom or could also be part of the cause. The pain may be felt all along the path of the nerve or may skip parts and just be felt in the foot or calf. Often the nerve pain in the leg may mask any feeling of pain in the back.
Serious Causes need medical diagnosis and/or treatment.
- Loss of bladder or bowel control need urgent attention
- Progressive weakness in the lower limb, i.e. foot drop where you cannot lift your foot
- Disc herniation where the disc swells and bulges pressing on nerves
- Disc prolapse where the middle part of the disc, the nucleus pulposus bulges through the outer ring of the disc
- Stenosis, narrowing of the spinal canal from a variety of causes
- Spinal problems such as spondylolisthesis, where one vertebra slips forward over another and corda equina
- Rare causes can be cysts, epidural veins, and tumours
Less Serious Causes can also be debilitating and vary in intensity. Common causes can be from postural imbalances, particularly from prolonged sitting or desk work with poor ergonomics; especially combined with a lack of proper / appropriate exercise. Couches are responsible for many back problems as they may not support your posture well and often encourage slouching. Myofascial imbalances, muscle spasms, minor accidents or injuries, inflammation, and postural / biomechanical changes, such as those in pregnancy can all cause sciatica.
Exercises with disc problems, can depend on where the bulge is as to the exercise needed / tolerated. Many disc problems occur from bending forwards, e.g. lifting. In these cases, forward bending exercises can aggravate and what is needed is more strengthening and lengthening towards gentle backward bending. This is particularly true where you are unable to sit down. https://www.youtube.com/watch?v=n0O_SHJAO6c shows some simple sciatica stretches. The muscles along the entire nerve pathway as well as the back will need stretching and strengthening at some stage of recovery. Coming soon is another simple video of stretches and strengthening exercises for sciatica where you can bend forwards; including stretches all related muscles along the nerve pathway.
Osteopathic Management Studies are conflicting regarding preferred management. Manipulative therapy showed useful for back pain though not always for sciatica. Targeted exercise and stretching can be helpful; bed rest is not helpful and staying active and strong is important in the long term; though debilitating pain of acute sciatica can make it difficult to exercise. Acupuncture dry needling to specific muscles helped as did targeted deep soft tissue massage.
We are happy to advise you on your health matters.
Lin Bridgeford DO KFRP MICAK MICRA FSCCO MSc
Registered Osteopath & Kinesiologist & Senior Yoga Teacher
Master Hypnosis and NLP Practitioner
Aether Bios Clinic
Saltdean
01273 309557 07710 227038
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