Wednesday, 23rd September 2020

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Sciatica: What is it?

Sciatica: What is it?

By Paul Knight at Estepona Osteopathic Clinic ( 0034 625 957 673 & Gibraltar: 00350 200 40563)

Sciatica is a symptom, not a diagnosis. It is described as a sensation experienced along the course of the sciatic nerve. It is generally painful and can be extremely debilitating. Patients may also experience numbness, pins & needles, burning, aching, etc…

The sciatic nerve is very large, it is formed by the union of four separate nerves (Roots) that arise between the vertebrae in the lower back. The nerve provides the ‘electrical’ supply from the brain down to the back of the thighs and the whole of the lower leg as far as the toes. It also carries information back to the brain, and it is along this path that we feel pain.

The symptoms develop in one, some or all of the following: lower back, buttock, back of the thigh, behind the knee and into the lower leg, foot and toes.If you lie on your back and try to lift your leg with the knee straight, the pain worsens. It may also worsen with coughing, sneezing, bending forwards, straining on the toilet etc. It is often worse in the mornings, or after sitting or standing for prolonged periods.

There are many reasons for pain along the course of the nerve:

  • Inter-vertebral disc prolapse or herniation (‘slippeddiscs’), or disc inflammation
  • Disc degeneration and osteoarthritis of the spine (‘wear & tear’)
  • Osteoporosis, causing vertebral collapse
  • Spondilolithesis (fracture and/or forward slippage of a vertebra) and disc instability.
  • Cysts and tumours of the spine, cord or part of the brain itself.

There are other, more uncommon causes, but it is important that someone who develops sciatica be assessed properly by an experienced practitioner, to ensure that there is no underlying problem. The major danger with severe sciatica is where the nerve supply to the leg or pelvic organs is so badly interrupted that power and sensation is lost, and may not be regained.


Treatment depends on the duration and severity of the sciatica:

  • Rest - avoid anything that aggravates the pain. Try and avoid bed rest.
  • Treatment - assessment by your doctor or osteopath would determine the cause and best treatment option. This will usually involve reduction of local inflammation, improvement of mobility of the back while discouraging tethering of the nerve to surrounding structures.
  • Pain relief medication may be required. Epidural is not a favourite option, but it should be considered before surgery if not responding to treatment.
  • Surgery is the last option and, if undertaken, is usually quite successful.

If symptoms last for more than a couple of days, or are very severe, you should see either your osteopath or GP as soon as possible. Delaying treatment will possibly prolong the symptoms. An Osteopath will asses you properly, and safely to determine the cause.

If appropriate, you will receive gentle treatment to settle the local inflammation and restore spinal mobility. An osteopath may suggest medication and exercise where appropriate. If there anything worrying is present, this will be quickly identified and he will direct you accordingly, for x-ray, M.R.I. scan or further investigation. Call now to enable osteopathy to ease your aches and pains.

Osteopath Gibraltar -
Paul Knight Osteopathy Gibraltar, 25, City Mill Lane - Fit4life Medical Centre,
+350 200 40563
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Osteopath Gibraltar -

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