We commonly see patients in clinic presenting with sciatic pain – a deep, gnawing pain down the buttock, into the back of the leg, sometimes electric, shooting or stabbing. It can occur with or without lower back pain, and with or without a limp when walking.

It’s a quite poorly understood pain condition, part of a family of pains called neuralgia. Neuralgia literally means “pain with a neurological cause” – but sadly that’s not enough to make a diagnosis.

The problem really lies with the fact, that for many primary health practitioners, sciatica is a good enough diagnosis. But the word sciatica is just a descriptor of a patient’s symptoms, rather than a proper analysis of their cause.

 

Not all sciatica is the same

Sciatica can be caused by a few different things. The first type of sciatica is when one of the nerve roots that contribute to the sciatic nerve get pinched or compressed where they exit the spine. This can be caused by a bulging or herniated disc, or inflammation and muscle spasm from simple mechanical back pain.

The second type of sciatica can occur when the sciatic nerve becomes compressed where it travels through the gluteal muscle group, if they are tight. A small percentage of the population also have a small anatomical anomaly, where the nerve actually pierces a small muscle in the glute complex called piriformis – this is known as piriformis syndrome.

 

So why do you have pain?

The overarching theme between these two causes of sciatica is compression of the nerve. It is this compression that causes the neurological signals back to the brain to be misinterpreted as pain.

We know now from the extensive research conducted in the areas of pain science and neurology, that all pains we experience, regardless of their cause, are generated by the brain as a response to neurological stimuli. When the brain receives altered messages from the sciatic nerve, they are interpreted as pain in the distribution of the compressed part of the nerve.

 

How do you know what type of sciatica you have?

 Your Osteopath can help you find out! Osteopaths are trained in simple orthopaedic and neurological testing – so they can test all the different structures and tissues in your body that may be compressing the sciatic nerve, and therefore quite accurately determine the root cause of your sciatic pain.

Once your Osteopath has determined the exact cause of your sciatic pain, it will be much easier to work out an effective treatment plan to help reduce pain and get you back to doing the things you enjoy.

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