Sciatica

First things first:

Not all pain down the leg is sciatica.  In fact, it is often over-diagnosed.  Sciatic pain comes from irritation of the sciatic nerve, which runs down the back of the thigh and leg towards the outer edge.  This is where the pain is felt and it's quite unique - more like a deep toothache or even 'electric' compared to simple muscular pain.

Pain down the side or front of the leg or thigh is not sciatic, and some pains in the right area may be due to referred pain from other structures such as spinal joints.  Other nerves can also come into play.  For example, the femoral nerve is associated with front of thigh pain.

 

What causes it?

The nerve can be irritated by mechanical compression from a tight muscle or a protruding disc pressing on it in the lower back, or by chemical irritation.  This may happen if a nearby structure in the lower back has been injured.  The chemical 'soup' produced during the healing process of inflammation is irritating in itself, but the accumulation of liquid pressure in the limited space of the spinal joint can also compress the nerve.

There are other less common causes of sciatica which can not be treated with manual therapy, and these will need to be considered and ruled out during your consultation.

Can we help?

Yes!  The first step is to find the location and cause of the irritation; usually in the buttock or lower back.  Most of the treatment will then focus on stretching and relaxing the muscles if that is the fault, or getting more movement in the affected spinal joint.  De compressing the nerve will also help recovery. 

It can be much harder to treat in the elderly or in people with advanced wear and tear.  In such cases there is often extra irregular bone growth narrowing the bony tunnel through which the nerve runs between the bones of the lower back, and if everything else fails, surgery may be the only  alternative to widen and smooth out the tunnel.