Sciatica is the name given to buttock and leg pain which comes from the low back. This is sometimes accompanied by tingling, numbness and weakness into the leg and foot.
It can be extremely painful and really restrict what you can do. Sciatica can start suddenly, in which case we would call it acute sciatica. Or, it can have crept on slowly over many months or years, which would be termed chronic sciatica. One of the most common types of sciatica that we see in clinic is ‘acute on chronic’. This person would have ongoing back pain and annoying sciatica, with occasional nasty flare ups.
A test that we use to help assess a patients sciatica is called a slump test. You can try this at home if you like. We use this alongside many other diagnostic tests to determine if you have sciatica and if so what is causing it.
Sit in a chair and slump forward. Straighten the knee on your good leg, and then bend it back down. Repeat for the effected leg. If the effected leg seems restricted, or the straightening causes the leg pain to worsen, or provokes pins and needles, this is suggesting that you might have sciatica.
Common causes of sciatica are;-
- Bulging lumbar discs
- Narrowing of the gaps between the vertebrae that the lumbar nerves travel through.
- Muscle tightness in the back, buttock and thigh muscles
Treatment depends on what is causing your sciatica. In clinic we would consider massage, manipulation, acupuncture and lots of advice, reassurance and exercises. Most acute sciatica settles with these approaches. Chronic sciatica can also be improved if you are able to continue with daily exercise and self help to maintain the improvement.
A simple safe stretch to try if you are in pain and think that you have sciatica is this gluteal (buttock) stretch.
Most sciatica will improve with time, and with non invasive measures. Very occasionally sciatica may be a sign of something more serious going on. I have worked in an NHS low back Pain and Sciatica Clinic for 13 years and am experienced in assessing whether further tests and investigations are needed. I can liaise with your GP about this if necessary.
Rarer more serious causes of sciatica, and what to look out for will be covered in my next blog.
If you would like further information, or would like to book an assessment please get in touch!
Blog Author – Mike Bruce BSc. (Hons.), BSc.(Ost.)
After graduating with a first class degree from Nottingham University in Biology, Mike went on to study osteopathy at the British School of Osteopathy in London.
Mike works privately in Plympton and on an NHS Back Pain Clinic in Devonport. He has a special interest in Nerve Root Pain, Sciatica and Ergonomics.