Osteopathic treatment for sciatica

Sciatica is the medical term used for pain that travels down the back of the whole leg to the ankle and can even affect the sole of the foot.  Sciatic pain can come on gradually or virtually overnight but the main symptom is pain or discomfort that usually develops from one side of the lower back and radiates down one leg.

Individuals who suffer from sciatic pain will find that the pain varies greatly both in intensity and in location, between patients and sometimes in the same patient.  In some cases an individual will have minimal pain that feels like a slight ache or pins and needles but in other cases the pain can be extreme, making any movements excruciatingly painful.

The pain follows the path of the sciatic nerve which reaches from the lower back through the buttocks, down the length of the legs and into the feet and toes.  Although sciatic pain can affect anyone at any age it tends to be more common in men over the age of 40 and can last for days, weeks, months or even years.  The sciatic pain is also common in women who are pregnant and have poor flexibility in the lower back.

The cause of sciatica is usually pressure being placed on the sciatic nerves when one of the discs becomes inflamed or ruptures.  This disc injury can be a result of osteoporosis, arthritis, injury to the ligaments around the disc, constant pressure due to pregnancy, excessive weight gain or even certain repetitive physical exercises.

It is important to bear in mind that the term sciatica is not a diagnosis, but rather a description of a symptom.  Importantly, the osteopathic physician should also look for the cause of the symptom in order to decrease the possibility that these same issues will arise again in the near future.

Treatment by an osteopathic physician for sciatic pain is usually conservative at first.  This is because most commonly the pain will greatly diminish or even disappear within the first month when the patient is able to support the back and avoid all strenuous physical activities.  Physicians will recommend application of ice packs for 10 to 15 minutes two to three times a day.  It is important to remember never to place ice directly over the skin but in fact to use ice packs specifically produced for this activity.

Individuals who get adequate amounts of sleep and potentially take anti-inflammatory drugs may also find great relief from sciatic pain.  Occasionally doctors will recommend injections of corticosteroids into the space around the spinal column for temporary relief of pain and decrease in inflammation.  At this time there is little or no clinical evidence that injections into the space have any benefit to treatment of sciatic pain.

Doctors will also strongly recommend that bed rest of greater than 24 hours may decrease the functionality of the individual and in fact increase the stiffness of the lower extremities.  Activities should be limited by pain but individuals should also be encouraged to move around occasionally.  It is important to use a firm mattress so the lower back is not under any greater stress.

Individuals who suffer from lower back pain may also find that sleeping with knees bent and a pillow supporting the legs will reduce the pressure to the lower back and therefore reduce pain and inflammation.  When sleeping on the side, place a pillow between the knees to keep the legs in a biomechanically correct position.

Using Osteopathic Movement Techniques the doctor will help reduce the swelling and pressure around the disc that is placing pressure on the sciatic nerve root.  They can also help to reduce contractions of specific muscles that may be putting extra pressure on the sciatic nerve.  Oftentimes once the pain has subsided the physician will also recommend exercise in order to strengthen the core muscles and decrease the likelihood of a re-occurrence.  These exercises should be supervised by a physical therapist in order to decrease the risk of further injury.

Individuals can help to take care of their own back by keeping physically fit and exercising to strengthen abdominal muscles and back muscles.  It is important to maintain good posture, both when sitting and standing that will avoid increasing pressure placed on a sciatic nerve roots.  Men should avoid carrying their wallet in the back pocket or keep its contents to a minimum because when seated this while it offsets the hip.

In my practice, Sciatica is something that I see for about 40% of the time. I have a protocol and treatment stratergies that can help patients get out of pain. Do whatsapp me or drop me an email if you need my help. Until then, stay safe everyone.