Sciatica is a common and often debilitating condition that affects millions of people worldwide. It is characterized by pain that radiates along the sciatic nerve, which runs from the lower back, through the buttocks, and down the back of each leg. In this article, we will delve into what sciatica is, its various causes, how it can affect individuals, the available treatment options, and the benefits of osteopathic treatment for sciatica.

What Is Sciatica?

Sciatica refers to the symptoms that arise when the sciatic nerve becomes irritated or compressed. The most common symptom of sciatica is pain, which can range from mild discomfort to severe and debilitating. Other symptoms may include tingling, numbness, or weakness in the affected leg or foot. It’s essential to note that sciatica is not a medical condition itself but rather a set of symptoms caused by an underlying issue.

Causes of Sciatica

  1. Herniated Disc: One of the leading causes of sciatica is a herniated or slipped disc. When the soft, jelly-like center of a spinal disc pushes through the tough exterior, it can press against the sciatic nerve, causing pain and discomfort.
  2. Spinal Stenosis: This condition involves the narrowing of the spinal canal, which can put pressure on the nerves, including the sciatic nerve. Spinal stenosis is more common in older individuals.
  3. Piriformis Syndrome: The piriformis muscle, located in the buttocks, can sometimes irritate or compress the sciatic nerve, leading to symptoms similar to sciatica.
  4. Spondylolisthesis: This occurs when a vertebra slips out of place and puts pressure on the sciatic nerve.
  5. Trauma or Injury: Physical injuries or trauma to the lower back can cause sciatica symptoms.

How Sciatica Affects People

The symptoms of sciatica can vary widely from person to person, but the most common complaint is pain that radiates from the lower back down one leg. This pain can be sharp, shooting, or burning and is often accompanied by numbness, tingling, or weakness. The intensity of the pain can range from mild discomfort to excruciating and may interfere with daily activities, such as walking, sitting, or standing for extended periods. In severe cases, it can lead to muscle atrophy and loss of function in the affected leg.

Treatment Options for Sciatica

  1. Conservative Management:
    • Rest: Taking a break from activities that worsen the pain can help alleviate symptoms.
    • Physical Therapy: Targeted exercises and stretches can strengthen the back and alleviate pressure on the sciatic nerve.
    • Medications: Over-the-counter pain relievers or prescription medications, such as muscle relaxants and anti-inflammatories, can help manage pain and inflammation.
    • Heat and Cold Therapy: Applying heat or cold packs to the affected area may provide relief.
    • Epidural Steroid Injections: Injections of anti-inflammatory medications directly into the spine can reduce inflammation and relieve pain.
  2. Surgical Options:
    • When conservative treatments fail to provide relief, surgery may be necessary. Surgical procedures can include discectomy (removal of a herniated disc), laminectomy (removal of part of the vertebra), or spinal fusion.

Osteopathic Treatment and Sciatica

When someone presents with symptoms of sciatica, the first thing the osteopath must do is try to understand the most likely cause, by taking a thorough case history and making a full examination. They will then discuss with the patient the best way to treat and manage the condition. Part of this process will usually include conservative treatment to see how much relief can be obtained with manual therapy. There is potential for a large amount of relief by using hands on therapy to restore biomechanical balance around the pelvis and lower back, which has the effect of reducing muscle spasm and joint inflammation. This may help if the nerve is getting pinched due to joint impingement and inflammation at the base of the spine, or due to piriformis spasm.

More about disc prolapses in the lumbar spine

Quite a common cause of sciatica is intervertebral disc prolapse or herniation.The natural progression of a disc prolapse typically involves several stages. Initially, the disc may experience small tears or damage, leading to the gradual weakening of the disc’s outer layer. As this process continues, the inner gel-like material of the disc may begin to push against or herniate through the damaged outer layer. This herniation can put pressure on nearby nerves, such as the spinal nerve roots or the spinal cord itself. Over time, this pressure can cause various symptoms, including localized back pain, radiating pain into the limbs (such as sciatica), numbness, tingling, or muscle weakness. In some cases, the body’s natural healing processes can help reabsorb the herniated material, leading to symptom improvement over a period ranging from a few weeks to months. Ultimately, the long term outcome varies with most individuals obtaining relief through conservative treatments, while much fewer may require surgical intervention. We recommend only going ahead with surgery if absolutely necessary.

Following the examination your osteopath should have a good idea if you are likely to have a disc injury. Unfortunately there are no manual therapy treatments that can correct a disc injury, but treatment will involve helping reduce spasm and maintaining function while the disc heals. Your osteopath will help manage the problem and also monitor the degree of any neurological defect caused by the pressure on the nerve.

Important; It is worth noting that if you are experiencing any disruption to normal bowel or bladder function, or any altered skin sensation around the back passage or genital area while having sciatica, you should seek immediate medical advice due to the risk of cauda equina. Also seek prompt medical advice if the sciatica goes into both legs at the same time or if you start to notice weakness in any of your muscles in the legs.


Sciatica can significantly impact an individual’s quality of life due to its often-debilitating symptoms. Understanding the various causes and available treatment options is crucial for managing this condition effectively. Osteopathic treatment, with its holistic and non-invasive approach, can be a valuable addition to the arsenal of treatments for sciatica, offering relief, promoting healing, and addressing the underlying issues that contribute to this painful condition. If you are experiencing symptoms of sciatica, consult with a healthcare provider or osteopath to explore the best treatment options for your specific situation.

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