Sciatica, nerve pain and slipped discs

AdobeStock_56438305This term is commonly used to describe pain in the leg or buttock. Often the cause of this pain is the lower back, which is irritating the nerves, for example from injury to a disc. True sciatica, from sciatic nerve entrapment or irritation, can cause severe pain or burning in the leg, pins and needles, numbness and weakness or any combination of these unpleasant symptoms.

Sciatic pain can also occur due to spasm of a muscle deep in the buttock, known as the piriformis, which can also trap the nerve. The condition can mimic that of a disc injury, but is usually much easier to correct with osteopathic treatment.

Trapped nerves tend to be one of the most painful conditions we see in clinic. Nerves can become trapped as they pass through narrowed spaces, like the spinal canals or under muscles. Most trapped nerves tend to cause pain in the arms or the legs, but they can occur in other areas too. A nerve pain is often described as sharp, shooting or burning and can also present as pins and needles or numbness and weakness in an area. The pain can vary from being mild to severe. Some of the more common entrapments include sciatica, which causes pain down the leg, or brachial plexus entrapment which causes pain in the arm.

How can we help…
It is important that we assess both why the nerve has become trapped or irritated and where. To do this a full history and examination is carried out by your osteopath which will include testing how your nerves function. Treatment, if appropriate, will aim to reduce spasm and to take pressure off the nerve. We will also focus on teaching you how you can help to lessen symptoms and what to do in your daily routine. Exercises may also be given to reduce your symptoms and to increase your mobility.

The easiest way we can imagine a disc is like a jam donut. We have the yeast (annulus) outer part and the jam (nucleus) central part. Although we commonly hear the term ‘slipped disc’, no actual slip occurs. Instead we have a bulge of the jam into the yeast (a disc prolapse) or the jam can spill out of the yeast wall (a disc herniation). The outer annulus can become weakened over a long time from excess loading on it. This can be through heavy work, sitting, poor spinal function, poor posture, obesity, poor muscle tone, past injury and poor repetitive habits.

Pain will vary from person to person and is largely based on whether there is interference on any of the pain sensitive structures. Discal injury is most common at the very bottom of the low back and this can give rise to anything from mild irritation to sciatica. In severe cases it can also cause weakness in the leg and loss of control of the bladder and bowel.

Disc injuries may require an MRI scan for accurate diagnosis, but your osteopath will advise you on this and will be able to refer you privately if need be. It is important that any leg symptoms are checked out quickly, as early intervention can often prevent more serious and painful conditions developing. Whilst medication may help with the pain, it does not address the cause. An osteopath will look to address the cause and will treat, if appropriate, using effective, gentle treatments to ease the pressure on the discs.

If your osteopath feels they are unable to help, they will advise as to the most appropriate course of action for you.