Guest blog: What is sciatica? By Charlotte Mead, osteopath

Guest blog: What is sciatica?

By Charlotte Mead, M. Ost.

The term sciatica is widely misunderstood and misused. It actually means pain referring in a line down the back of the leg, along the path of the sciatic nerve. It is a symptom, not a diagnosis, and can occur for many reasons. The severity of the pain can range from mild discomfort to severe pain, and can be accompanied by pins and needles, numbness and muscle weakness.

Image from University of Maryland Medical Centre

To explain why sciatica is so variable, let’s talk anatomy. The spine is made up of vertebrae stacked in a column, inside of which is the spinal cord. At each spinal level, individual nerves come out of the cord and go off to supply different parts of the body. The sciatic nerve is formed from a bundle of nerves that come out of the spine at L4 to S3 – the very bottom levels of the spine. These nerves supply the skin sensation on the back of the leg and foot – which is why some people get pins and needles or numbness. It also supplies a lot of the leg muscles – which is why some people experience weakness.

Sciatica happens when the sciatic nerve is irritated, compressed or compromised in some way. Where and how much this is happening determines the specific type of sciatica that is experienced.
One of the most common problems leading to sciatica is a bulged or prolapsed disc. Imagine the discs between each vertebra as cushions – with a soft gooey centre (the nucleus) and a tougher more elastic outer (the annulus). If the nucleus pushes into the annulus it causes a bulge, or if it pushes through than it spills out into the spinal canal. There is not much space in there, so if the nucleus bulges or prolapses, it presses on the structures closest to it. In these lower spinal levels this often affects the sciatic nerve and can take anywhere from weeks to months to heal. It needs careful management from a musculoskeletal specialist. Manual therapy can help relieve the symptoms.
Another common cause of sciatica is due to compression of the nerve further down its path as it travels through the muscles that control the hip. These can become tight for a whole variety of reasons, from how you sit at work to having one leg longer than the other or a problem further up in the spine affecting your posture. It can be managed with stretching and manual therapy, but the underlying cause will need to be identified and dealt with to prevent recurrence.
The main thing to take away from this blog post is that sciatica is a symptom not a diagnosis, and until the underlying cause is identified and controlled the sciatica may return. Skilled manual therapists can identify the underlying causes and treatment can both reduce your symptoms and prevent recurrence. Don’t live in pain and hope it will go away – take control and get it dealt with!


About Charlotte Mead, M. Ost.

Charlotte studied at the British School of Osteopathy and holds a M.Ost Master Of Osteopathy Degree. Prior to qualifying as an osteopath, Charlotte worked as a Sports Massage Therapist for four years, including treating runners at the London Marathon. She has clinics in Berkhamsted, Amersham, and central London. She also provides an in-house corporate service to the head office of a national company. Charlotte is a member of the British Osteopathic Association and is fully insured, CRB checked and registered with the General Osteopathic Council. In her spare time she enjoys live music and keeping fit with Zumba!

See Charlotte’s website