A cure for sciatica please
If you’re looking for a cure for sciatica, you’ve come to the right place. But first I’m going to explain why this is a naive question. Then I’ll explain how you probably can achieve a cure for sciatica. And it likely won’t be the way you expect.
“Cure for sciatica” – why so naive?
Remember that “sciatica” is a description and not a diagnosis. It’s like going to the doctor complaining of a pain in your head. Then the doctor tells you you have a headache. Sciatica means pain, tingling, and/or numbness in the distribution of your sciatic nerve. Here’s the Merriam-Webster dictionary definition (which is a bit vague itself). So it’s a naive question to ask, because you’re not curing the cause, but trying to cure a symptom. Always a bad approach. The sciatic nerve supplies part of the buttock, back and outside of thigh, and everything below the knee. So symptoms in that area could be described as “sciatica”.
What causes sciatica?
I’ll say it again – “sciatica is a description and not a diagnosis”. But what are the potential causes? I split sciatica into two broad types: nerve-compression and non-nerve-compression sciatica.
1. Nerve-compression sciatica
The sciatic nerve or one of its tributary spinal nerves (L4, L5, S1, S2 and S3) may be compressed. If this happens you will almost certainly experience sciatic symptoms. Although there are people with compression of these nerves without sciatic symptoms. MRI studies have shown that you can have nerve compression without symptoms. My theory is that if this compression builds up slowly over time the nerve adapts and is less likely to become irritatable.
2. Non-nerve-compression sciatica
If one of the structures in your lower back/buttock area is injured this may produce pain. This pain can be referred to other structures supplied by the same spinal nerves. This is called referred pain. Think of it like crossed wires. Your brain doesn’t know where this pain is originating from. It projects it into other areas of the sciatic distribution. The neurological processes behind referred pain are understood and widely accepted. Look up convergence projection theory; convergence-facilitation theory; axon-reflex theory and thalamic convergence theory. If you have the stomach for the science.
What about that cure for sciatica then please?
First establish the cause / diagnosis
So the first step is to work out whether you have nerve-compression or non-nerve-compression sciatica. You’ll need a half-decent clinician for that. Because this can only be determined by examination. We’d be looking at your
- tendon reflexes
- muscle power
- skin sensation
- Straight Leg Raising Test
- and a few other tests
If you have nerve-compression sciatica, there are some potentially serious causes. But the most common (and treatable one) is a lumbar disc herniation/prolapse. If you want to exclude the potentially nasty causes of sciatica (about 1 in 1000 cases), check out these questions.
Second treat the cause, not the symptom
Whether you have nerve-compression sciatica or non-nerve-compression sciatica, there probably is a cure for sciatica. Treat the cause, and not the symptom. There are things you can do to encourage your body to heal. Our Principle Number 3 at Active X Backs is “The body can heal itself”. There are a few causes of sciatica that are very amenable to manual therapy. If you have a disc prolapse, you might think surgery is the obvious and only choice. But you’d be wrong. If you give the body the optimum conditions for healing, many disc problems can be healed over time (I have helped in this process hundreds of times). My number one rule is always “use it or lose it, but don’t abuse it”.
Just ask us for help
I’ve been an osteopath in Edinburgh for 27 years, specialising in lower back pain and sciatica. If you’d like help pinning down your own cause of sciatica, then book an in-clinic or skype consultation online here. Or call Andreea or Paula and we’ll squeeze you into the diary as soon as possible.