Sciatica

Sciatica - A real pain in the butt

 
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Sciatica or sciatic pain is classed as pain caused by irritation of the sciatic nerve, which can occur at the low back, tailbone region or deep in the backside. The sciatic nerve is the thickest and longest nerve in the human body, starting from the low back and running to just below the knee before branching off into smaller nerves. Some causes of sciatica include herniated/bulged disc, piriformis syndrome, degenerative disc disease and foraminal stenosis. Sciatic pain can be a real pain in the butt (lame – I know), however, most people probably don’t know the pain they are experiencing in that region isn’t actually sciatica at all! There are similar symptoms to sciatica that occur within the surrounding region that we unknowingly call ‘sciatica’. Yes, sciatica is a pain that is felt in and around the backside (can also occur down the leg), but there are many other causes that can present in a similar fashion. The backside/pelvis is a large, complex region with multiple functions, therefore many muscles, tendons, nerves and ligaments that can be affected. People often make the mistake of thinking that any type of pain in that area must be sciatic pain, when in fact the cause is something else.

5 common causes of symptoms replicating sciatica include:

  • Piriformis muscle pain

  • Gluteus Medius strain/tightness

  • Sacroiliac Joint (SIJ) pain

  • Hip bursitis

  • Upper Hamstring Tendonitis

So, what can we do to decrease these symptoms? Generally, there are some stretches that can really help loosen up the area, exercises and strengthening that target specific muscles in and around the hip to decrease the load on others, and manual therapy to help balance and release the area. As an Osteopath, we perform a full assessment of the hips, pelvis, spine and any other related area/structure to find the cause behind your sciatic pain. Providing treatment is the right course of action, we then go about releasing and balancing the structures in question through a variety of techniques including massage, manipulation, articulation and PNF/MET. Usually some form of strengthening exercise is prescribed to aid in the management of sciatic pain. Obviously, not all conditions are suited to manual therapy and exercise and there are occasions where we need to refer out for further action (ie. surgery, injection, medication).