The left and right sciatic nerves are the largest nerves in the body and run from the base of the spine down the back of each leg. The sciatic nerves supply both sensation and motor function to the legs and are made up of several individual nerves that branch off from the spinal cord through the vertebrae.
Sciatica is a pain felt in either one or both legs with possible tingling, numbness or weakness caused by the pinching of the sciatic nerve along its pathways. It’s rare for sciatica to occur before the age of 20 due to the suppleness of the structures that surround the sciatic nerve. As we age, those structures start to degenerate or become tight, leaving the nerve vulnerable to becoming pinched along its pathway. Researchers have estimated sciatica affects up to 43% of the population at some point.
Symptoms of sciatica
Usually, sciatic only affects one leg, but in more serious lower back injuries, it may be bilateral. Sciatica can cause a variety of symptoms, of which the most common are:
- Numbness, tingling, burning or weakness in the buttocks or legs
- A sharp pain that may make it difficult to stand or walk
- Sharp shooting pain that travels down the leg in a line, often into the foot and toes
- Pain that is constant in only one side of the buttock or back of the leg
- Pain that is worse when sitting.
These symptoms can be constant or develop when moving.
According to research, individuals who are obese, overweight or who smoke are at greatest risk of developing sciatica. Smoking has been shown to dehydrate and degenerate spinal discs, leaving them vulnerable to bulging against a nerve.
Many people who suffer from sciatica often get better within a few weeks on their own, but with others it may take many months. It all depends on what has caused your sciatic symptoms. It’s important to identify the cause as early as possible as limping to avoid the pain can often trigger a separate set of symptoms.
7 Most Common Causes of Sciatica
The seven most common causes of sciatica are as follows:
Degenerative disc disease
Intervertebral discs, like cartilage, don’t have a blood supply. This means a disc’s ability to repair and regenerate isn’t as efficient as that of a muscle, for example. As you age, the volume of fluid within each disc lessens, weakening the structure and leaving it vulnerable to bulging out against a nerve. This can cause sciatic type pain if the disc that is bulging against the nerve is in the bottom third of the spine.
Lumbar herniated disc
Herniated discs occur when the gel-like material inside an intervertebral disc pushes against the outer coating, causing it to bulge. This bulge can then push against the nerve that runs alongside it.
Additional terms used to refer to a herniated disc are slipped disc, prolapsed disc, bulging disc or protruding disc. The most common symptom of a lumbar herniated disc is sciatica pain.
Lumbar spinal stenosis
Stenosis occurs when the space between the spinal joints is narrowed. You have nerves that travel next to this space, and they can often become irritated as the space between the joints lessens. It often develops over time as a result of degeneration in the spinal joints as we age, and is most common in people over the age of 60.
Piriformis syndrome
One of the most common causes of sciatica is when the sciatic nerve becomes pinched by the piriformis muscle. The muscle itself is one of the deep buttock muscles and in 30% of the population the nerve runs directly through it, leaving these individuals more vulnerable to pinching. Humans weren’t designed to sit for as long as we do in the 21st century with the growth of desk-bound jobs. This plays a role in the development of tension in the piriformis. The good thing is that it is one of the easiest forms of sciatica to resolve with alternative treatments.
Sacroiliac joint dysfunction
When the sacroiliac joint is irritated it can irritate the lowest lumbar nerve as it runs alongside the joint, causing debilitating sciatic type pain as the joint is moved with minor movements such as walking.
Muscle strain
If any of the muscles along the pathway of the sciatic nerve suffer a strain and it isn’t treated properly, then it can cause scar tissue to form over that strain. This scar tissue can potentially put pressure on the sciatic nerve.
Pregnancy
The weight of a baby can cause many of the muscles that surround the sciatic nerve to tighten around it, causing symptoms of sciatica. Also, a hormone called relaxin is released during the third trimester of pregnancy. This hormone does what its name suggests, and relaxes ligaments in the pelvis to allow for the baby to travel through easily during labour. The relaxing of these ligaments can cause the pelvis to misalign, which can pinch some of the nerves that run through the area, leading to sciatica pain.
Conventional treatment for sciatica
The usual medical treatment for sciatic consists of prescribed or over-the-counter medications to reduce inflammation and pain. Nonsteroidal anti-inflammatory drugs (NSAIDS) such as Ibuprofen can help if the sciatica is associated with any inflammation pressing against the nerve.
If the pain is due to tension in the muscles tightening around the nerve, then muscle relaxants such a diazepam can help. These aren’t long-term solutions though, and won’t address the root cause of your symptoms or help prevent them from coming back.
Long-term use of these types of medication can have negative effects on the health of your stomach and liver.
To help reduce the symptoms naturally and prevent them from returning, a more structured treatment approach is needed.
Natural sciatica treatments
The following are the most effective natural treatments for sciatica pain.
Heat and ice
Heat and ice can help for both acute and chronic cases of sciatica. If the sciatica is a result of an acute injury, such as straining a muscle, then you can use a procedure called contrast bathing. This involves placing ice or a cold compress over the area for 10 minutes and then, immediately after, placing heat over the area for 10 minutes. This can be repeated twice an hour if needed. If the sciatica is a result of piriformis syndrome, then sitting on a hot water bottle (ie with the bottle under your buttock) for 20 minutes can help.
Acupuncture
If the cause of your sciatica is tension in the leg and muscles tightening up around the nerve, then acupuncture can be effective at helping reduce this tension. Hair-thin needles (which are usually not felt) are inserted into the affected muscles.
Osteopathy
Osteopathy is a system of alternative medicine that helps both to identify and address the root cause of your sciatica. Several orthopaedic tests will be used to find out where the sciatic nerve is being pinched and then a combination of massage, stretching and gentle manipulation is used to take the pressure off the nerve. Several stretches will also be prescribed to help sustain the results and prevent the symptoms from returning.
Massage therapy
Again, if your sciatica is caused by tight muscles around the sciatica nerve then massage therapy can be an effective way of releasing those muscles, creating an environment for the sciatic nerve to operate without any irritation.
Osteopathy, Acupuncture and Massage have all been approved by the NICE Guidelines (National Institute for Health and Care Excellence). Both NHS and private doctors in the UK use these guidelines to inform them of appropriate treatments.
Oliver Eaton is a registered Osteopath, Medical Acupuncturist and Musculoskeletal Injection Therapist. He specializes in the treatment of sciatica, arthritis and headaches/migraines. Much of Oliver’s specialties were learnt through personal experience; suffering from a series of chronic conditions from which he made a full recovery using alternative medicine approaches. This sparked his passion for specializing in the treatment of patients with chronic pain. As one of the leading practitioners in his field on Harley Street, he has built his reputation on achieving results with patients who had previously had no success elsewhere. Oliver uses the latest diagnostic approaches to help identify the root causes of an individual’s sciatica. Once identified, he is able to use osteopathy or acupuncture to both help to resolve the symptoms and prevent them from returning, without the use of medication.
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