The roots of the sciatic nerve leave the spine at several levels in the lower back, enter the buttocks, and move down to the lower extremities. As strain is applied to the sciatic nerve in the lower back, it may cause discomfort and other sensations down the nerve to one of the legs—a disorder generally referred to as sciatica.
In younger and middle-aged adults, the most common cause of sciatica is herniated disc in the lower back at one or more points. Due to the structure of the sciatic nerve, the characteristics of the patient’s symptoms can guide the Osteopath to see where to look for possible causes in the lower back:
S1-2 Level (S1 nerve root): outer foot numb, difficulty walking on toes, weak Achilles tendon reflex
L5-S1 Disc (L5 nerve root): inner foot numb, weak big toe and heel walking, no reflex changes
L4-5 Disc (L4 nerve root): shin numb, weak heel walking, patellar tendon reflex loss
L3-4 Disc (L3 nerve root): medial knee numb, weak walking up steps, weak patellar tendon reflex
L2-3 Disc (L2 nerve root): front of thigh pain/numb, weak walking up steps, positive patellar reflex
L1-2 Disc (L1 nerve root): groin pain/numb, weak squat and steps, no deep tendon reflex
T12-L1 Disc (T12 nerve root): buttock numb, weak lower abdominal muscles, possible spinal cord compression
In sciatica patients under 55 years of age, the two lowest discs in the lower back—L4-5 and L5-S1—are the problem 95 percent of the time. The good news is that a systematic analysis of 49 published studies showed that spinal manipulation therapy, the main type of care given by Osteopaths, is an effective non-surgical preferred treatment for local and radiant pain relief in patients with a herniated disc in the lower back.
While sciatic pain is often initially acute and extreme, most cases can be successfully treated by non-surgery within three to six weeks; however, referrals to specialists or advanced imaging (such as MRIs) may be required to determine potential causes of pain if patient pain persists. Surgery is typically limited to people with neurological loss and/or intestinal or bladder control issues (the latter can arise in order to prevent persistence). As for many musculoskeletal disorders, the earlier care is obtained in the course of the disorder, the more likely (and faster) a good treatment outcome can be achieved.
Despite Tier 4 restrictions we are currently open and carrying out the strictest of hygiene practise, so you and your family can visit Cram Osteopaths in secure confidence.
Don’t suffer pain this winter and the earlier issues are dealt with, generally the better the recovery. Book online at www.cramosteopaths.co.uk