Everyone has a sciatic nerve! The Sciatic nerve originates from the lower portions of your spinal cord (Lumbar and sacral regions). Like a tree, your spinal cord is the big trunk and the main branches are the spinal nerves. The spinal nerves come out of the main spine, exiting the bones of the back. These branches travel down the back, through the buttock and then bundle together and become one very thick cord. The cord courses down the buttock, behind the knee and splits to feed different parts of the leg. It reaches as far down as the big toe.
This above picture shows just how complicated and wired we are! The thick yellow cord is the sciatic nerve. Can you follow it from where it starts and to where it goes? It’s very tricky!
Sciatica is when any part of this nerve gets irritated. Think of the nerve as a highway continuously sending signals down. If the highway gets damaged – traffic will slow down and can eventually come to a stop, and there will be lots of pain! Lots of pain! At TownOsteo we specialise in helping to “clear the highway!”
The main symptoms of sciatica we see in clinic are:
Shooting, pins, and needles or numbness down the leg, especially below the knee. On the whole, if the pain does not travel below the knee – we don’t tend to consider it as sciatica. Click here to see our article on sacroiliac joint pain.
A lot of discomfort when walking and sitting.
Weakness in the leg and foot muscles.
The main signs of sciatica we look for in clinic:
We (very gently) hit you with our mallet! We do this to check your reflexes. We check your individual muscle strengths and physically stress the nerves in different positions. We might even use very small and blunt needles to check the sensations on your skin. All this helps us to “read the nerve”. Giving us vital information on where the traffic jam is, what is causing it, and the extent of the damage.
We are well trained and experienced enough to ask the right questions and interpret the results to screen for anything serious. On occasion, we will ask your permission to write to your doctor, other times we will be happy to start treatment straight away.
We have an excellent network of private providers we can call on to assist us to help you. From companies that offer outstanding medical imaging services – to private practice doctors who will engage with you and our clinic in helping to provide answers and solutions.
Let’s talk about the different causes of sciatica.
We can’t write a complete list of all the causes of sciatica. To write and read about all the causes would take a very long time! So let’s cover in brief, a few of the main types we see in clinic. You can always book in for a consultation to discuss your particular type.
Spinal Disc Herniation
Yasin, One of Leicester’s Leading osteopaths and acupuncturists, is known for his light-hearted humorous approach, putting his patient’s worries at ease. He often describes the spinal discs to be like a Jam donought. Doughy on the outside, squishy on the inside. There are many different types of disc damage. The picture above is just one type (of herniated disc). It’s where the jam has squeezed out the dough. You can have types of herniation where the outer layers of the dough start to bow outward – pushing on the nerve that sits next to it. Types where the dough get damaged but leaves the jam protected. But the worst kind for our patients is where the jam squeezes out. In this instance the jam can stick on the nerve. In severe cases we might recommend you for specific types of nerve injections and beyond that – surgery. But we have a few tricks up our sleeve before that happens!
In cases of sciatica where we can help; treatment will be aimed at opening out the distance between the nerve and the damage. There-by reducing pressure on the nerve from the inflammation. Yasin is very hands on, in these cases his osteopathic approach is one of working with the spine to gap it open, loosen the pressure on the joints, rhythmically mobilise the spine to help aid movement of inflammation and clear the site. We have a rehabilitation room where we can show you exercises to speed up your recovery, at first, very gentle. We build on your ability and progressive your exercises.
Lumbar spinal stenosis
Stenosis is when “gunk” builds up to block the nerve or blood vessels that feed the legs. This is a very complex condition. At times and when the stenosis is stable; using a lot of hands-on-treatments, traction, mobilisations & spinal gapping, we can help alleviate some of the symptoms. TownOsteo prides itself in its honest approach. If and when we feel that treatment can no longer manage your symptoms – we sit down and have a frank conversation. The best route at this point often is surgery.
The sciatic nerve courses through the buttock. If it is established that sciatica symptoms are partly or wholly coming from problems in the buttock; at Townosteo we believe in a multi-modal approach to treating you. Yasin will combine soft tissue work, deep needling, therapeutic ultrasound, and exercising prescriptions to loosen and “free” the nerve from the pinch. This is where the different philosophies of osteopathy, physiotherapy and acupuncture all come together to formulate treatment that can work very quickly.