Sciatica, or to give it its technical term, lumbar radiculopathy, describes symptoms felt in the leg because of a problem with the nerves that come from the lower back. The symptoms can include a sharp shooting pain, pins and needles, numbness, tingling or burning. In more severe cases, weakness in some of the muscles of the leg can occur, which may cause problems with walking. The nerves are usually affected because of a problem with the lower back, so back pain is often felt at the same time, but sciatica can occur on its own. The pain of sciatica is most commonly felt in the buttock, back of the thigh, outside of the calf and the foot. Sufferers tend to find that sitting is the most uncomfortable activity, with bending usually also being affected.
It is estimated that between 13-40% of people will suffer with sciatica at some point in their life, most commonly affecting people in their 50s. The most common cause of sciatica is an injury to the intervertebral discs. The discs are cartilage structures that sit in between the bones of the spine. It is normal for these structures to become strained through normal everyday activity and most of the time we will be unaware of this happening. Such ‘normal’ disc injuries are seen on MRI scans in half of all young people without back pain or sciatica. Most of these disc injuries will heal without further problems and are then no longer visible on scans. However, every so often a disc injury does cause a problem. Usually, this is due to the human body’s own healing process, inflammation, which creates a chemical environment around the injury site that is irritating to the nerve and causes it to become painful. Sometimes, the strain on the disc can cause it to bulge, often referred to as slipped disc, and this can physically press against the nerve and cause pain. In both these circumstances, 75% of sufferers are usually feeling better after 4 weeks, with 50% of people being completely better in 6 weeks.
Sciatica often gets better on its own. Medication can help this process, and doctors may prescribe non-steroidal anti inflammatories such as ibuprofen, or simple pain killers such as paracetamol. In some cases, diazepam may be prescribed or special neuropathic pain drugs, such as pregabalin or gabapentin. If possible, it is best to maintain a normal routine. Gentle exercise and activity will usually help with the recovery process, as will continuing to go to work, or returning as soon as possible if the symptoms were severe enough to require a period of sick leave. Osteopathy can also help with the recovery process and is recommended as part of the care process by the National Institute of Heath and Care Excellence (NICE) who provide guidelines for the NHS. The movement techniques that are used can reduce pain and sensitivity within the affected nerves. This makes normal movement more comfortable, which facilitates normal healing. Exercises can also be advised based on an individual’s current level of pain and disability. Sometimes, sciatica may not resolve on its own and it can be helpful to have treatment such as osteopathy. A proper assessment by a trained healthcare practitioner, such as an osteopath or GP is also advisable, as in rare circumstances sciatica can be caused by more serious health problems that would require additional treatment.