Sciatica

Sciatica

Download our leaflet on Sciatica

Sciatica refers to pain along the large sciatic nerve that runs from the lower back down the back of each leg and is a relatively common form of low back pain and leg pain. The sciatic nerve is vulnerable as it passes beneath piriformis in the buttock, or through the hamstring, which is why Remedial and Swedish Massage are so effective.

Sciatica can be caused by pressure on the sciatic nerve from a herniated disc, also known as radiculopathy meaning that a disc has protruded from its normal position in the vertebral column and is putting pressure on the radicular nerve (nerve root), which connects with the sciatic nerve.

For some people, the pain from sciatica can be severe and debilitating. For others, the pain from sciatica might be infrequent and irritating, but has the potential to get worse. Usually, sciatica only affects one side of the lower body, and the pain often radiates from the lower back all the way through the back of the thigh and down through the leg. Depending on where the sciatic nerve is affected, the pain may also radiate to the foot or toes.

One or more of the following sensations may occur as a result of sciatica:

  • Pain in the rear or leg that is worse when sitting
  • Burning or tingling down the leg
  • Weakness, numbness or difficulty moving the leg or foot
  • A constant pain on one side of the rear
  • A shooting pain that makes it difficult to stand up

If you have sciatica your options are to go straight to the osteopath for a structural check – or go attend for Advanced Remedial Massage. These therapists will also be able to assist you in restoring structure.

WHAT IS SCIATICA?

Sciatica is a symptom not a diagnosis. It means that the big nerve in the back of the leg is irritated and inflamed. The cause could be a joint not moving properly, or a tight muscle, or from a prolapsed disc. Because nerves are very sensitive structures they can take a long time to recover and sometimes remain irritated even when the obstruction has gone. This does not mean the nerve is damaged, it means that the nerve is still in its protective mechanism and needs mobilising and stretching just like a muscle.

THE ANATOMY

The pelvis consists of two bones and the sacrum forming a ring.

The pelvic bone/innominate or what we often call our hips are in fact three bones which have fused by puberty. They are: the ilium where you rest your hands in the ‘hands on hips’ position, the ischium is your sitting bone and the two pubic bones form the front of the pelvic ring.

The sacrum (or keystone) supports the spine. It and the tailbone form the back of the ‘ring’.

The sacroiliac joint is the joint between the sacrum and the ilium.

sciatica1

SACROILIAC JOINTS (SIJ)

The function of these two important joints and the pubic symphysis is to allow you to twist the pelvis when you move your legs. There is little movement here as only part of the joint moves. When the normal ‘joint play’ or movement is lost, this can then lead to problems with surrounding structures such as the iliolumbar ligaments which link the pelvis to the lumbar spine, gluteal and other pelvic muscles. SIJ problems can cause a wide range of symptoms throughout the lower back and buttocks, thigh and/or groin.

SIGNS AND SYMPTOMS OF SIJ DYSFUNCTION

You will feel pain in the left or right of your lower back and this varies from a dull ache to excruciating pain and may travel to the groin or hamstring which may often be diagnosed elsewhere as sciatica. Turning in bed, difficulty putting on shoes, stiffness when getting up from sitting are common complaints, we hear a lot.

Studies have implicated that sacroiliac subluxations cause 50 – 70% of adult back pain. (Barbor R Back Pain BMJ 1978).

SYMPHYSIS PUBIS

This joint has a disc in between the bones and this is how the bones separate due to hormones at birth.

It is not unusual for us to discover pubic imbalances in both sexes, often coupled with sacroiliac joint problems.

During pregnancy, hormones change laxity. Distortions may occur in the pubis affecting the whole ‘ring.’ It is not uncommon to have back pain and pubic pain during pregnancy. It can be treated!

It is also a good idea for ladies to get their pelvises checked about 3 months after childbirth to prevent long standing problems.

GOOD IDEA TO CHECK ON CHILDREN FOR SIJ TOO

Falls can cause back pain from SIJ problems in children. In one study of children with back pain, 83.1% had SIJ problems. (Journal of Manpulative and Physiological Therapeutics vol 7 June 84).

SCIATICA

The most common form of sciatica is due to sacroiliac dysfunction. The pain radiates down the back of the leg – sometimes to the big toe. It can be compressed anywhere along its path – at the lumbar spine, sacroiliac joint, buttock or hamstring causing great pain and lifestyle problems.

HIP JOINTS

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These are ball and socket joints with a good range of motion. The muscles that move the legs are really hip muscles. They attach to the pelvis which means that the hamstrings at the back, the quads at the front, the IT bands on the outer thigh and the adductors on the inside (and hold you on your horse) need to be in balance with the smaller rotator muscles in your buttocks.

SPINAL JOINTS RELY ON STABLE PELVIS

As can be seen from the picture above, if the pelvis is out of alignment, then the whole spine right up to the neck will be affected. Stress on the electricals has far reaching effects on organs in the area.

Your migraine may be coming from a sacroiliac problem which may be being maintained by tight, shortened and spasmed hip/leg muscles!

ORTHODOX APPROACHES

In some schools it is not acknowledged that the SI joints move! The mind boggles! Treatments range from painkillers to anti-inflammatories; drugs that ‘tell’ your brain ‘all is well’ when it isn’t. It makes much more sense to sort out the structure so that the body can do its work. Scans and X-rays rarely show anything that we deal with on a daily basis. Very rarely are operations needed. Bulging discs may show on scans and myelograms but they are usually NOT the cause of the pain. Research confirms this too. Steroid injections should be a last resort as they like all drugs have side effects.

WHAT CAN WE DO AT BROOKS-CARTER CLINIC?

Remedial Massage addresses muscle imbalances, which occur when the body is continually fixed in one position or involved in repetitive actions – golf, tennis, piano playing, computer work, driving etc.

Remedial Massage is a treatment that can be applied specifically to help prevent an injury or the recurrence of a past injury as well as treating the injury itself.

Advanced Remedial Massage can be used to bring the body into balance using Muscle Energy Techniques which are gentle and effective.

Problems in the structure disturb the circulation and electricals throughout the body leaving the person vulnerable to many diseases.

Advanced Remedial and Sports Massage therapists treat and educate on management techniques for back and neck pain, headaches, referred pain, overuse injuries and postural complaints.

Reflexology helps the body to heal itself. Following illness, stress, injury or disease, the body is in a state of "imbalance", and vital energy pathways are blocked, preventing the body from functioning effectively. Reflexology can be used to restore and maintain the body's natural equilibrium and encourage healing.

Organs and body parts are represented on specific points on the feet thus problem areas can be treated/worked. Relaxation benefits are to be experienced!

Osteopathy is the science of human mechanics. It is a system of diagnosis and treatment which lays main emphasis on the structural and mechanical problems of the body which affect all organs and our day to day living. We are not here just to digest, secrete, excrete, circulate and breathe but we do so much more and are so much more.

We are a reflection of our actions! Our muscles, bones, joints and ligaments adapt to the demands we make – from cycling, to running, to cooking, to working – manually or at computers, to writing and speaking. Misalignment of the spine bones causes nerve stress – the electricals that ultimately fire your muscles. We work to correct spinal nerve stress using manipulation.

The osteopath assesses and treats faults that happen due to injury, stress or other causes. We want your body to work like a fine tuned engine with the minimum of wear, tear, stress and energy, leaving more energy available for living!

The Osteopath has a toolkit of techniques which can be ‘custom built’ for all ages to attempt to sort out all of the above. The body has a natural healing ability – we work with that.

Naturopathy involves lifestyle including diet –and this advice is available too.

All these therapies work well alongside orthodox medicine as well as on their own.

THERAPY OPTIONS AVAILABLE FOR THIS CONDITION AT BROOKS-CARTER CLINIC

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