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What is 'Sciatica'?

Posted on 17th Apr 2018

Many people mistake the word ‘Sciatica’ as being an actual medical diagnosis, when in actual fact it is merely a non-specific description of symptoms. 

The word is used by medical practitioners and implies a diagnosis, however it simply means that part of the sciatic nerve is irritated and offers no diagnosis as to what is actually causing the irritation.

Sciatica is used to describe pain that runs from the back or the buttock down the leg, sometimes to the knee, the ankle or into the foot. Symptoms range from mild, occasional pain to severe, unrelenting leg pain with pins and needles, numbness, loss of sensation and muscle weakness.  

Some people who have experienced this condition, or deal with it as medical or therapeutic practitioners, see it as something that cannot be cured and can only be ‘managed’ by medication, massage or exercise.  It would appear that this is a commonly held belief and I am asked on a fairly regular basis if I can actually treat sciatica.

I see my job as a physiotherapist not only to identify and confirm when ‘sciatica’ is the problem, but also to seek out the source of the problem and work at rectifying it through therapeutic means whenever possible.  I also believe, after over 35 years of experience as a physiotherapist, that the different irritants to the sciatic nerve are as numerous as the number of people who suffer the symptoms, as no two cases are ever exactly alike.  It is this very fact that makes effective treatment so difficult.  It is this very fact that leads many people on the internet to declare that there is no cure.  I do agree that there is no ‘one-size-fits-all’ solution.  However, it is this fact that makes therapeutic intervention to cure what many call ‘sciatica’ both a great challenge and extremely satisfying.

I never use treatment protocols (pre-written ‘recipes’ of how to ‘fix’ a particular problem, pain or diagnosed condition).  Instead, I identify the source of the problem by careful questioning and listening to an individual’s unique medical history.  I then use only manual techniques to gently load the tissue and identify where the primary problem lies.  This can literally be anywhere from head to foot and the source of a pull on the sciatic nerve can be remote (such as from membranes in the head) or more local (next to the nerve in the leg its self), or even a whole host of sources in between!

These two cases of past patients with Advanced Physiotherapy are good illustrations of how this is the case:

  1. The client was a middle-aged, Malaysian-born man with a hugely responsible job, lots of travelling and a moderate, but very irritating pain that began quite unexpectedly in his right knee. He sought help within weeks, but his pain quickly developed to acute, severe sciatic pain down the whole leg over the course of about 10 days and after his first 2 treatment sessions.  During his third session, we identified that he habitually sits on his feet, with his legs folded underneath him.  It transpired that the top of his right thigh was extremely tense and the soft tissue in particular was twisted.  Through part of that treatment session he could actually feel the bone as if it untwisting and straightening out on the inside.  The difference from before treatment to the result was, in his words, “Night and Day”. From that point on, his symptoms began to amend dramatically and he needed minimal further intervention.  The main cause to the irritation of his sciatic nerve was very close to the nerve and its source in the pelvis.
  1. Another client was a lady in her mid-40s who had suffered severe and intractable left-sided leg pain for 14 years since the birth of her second child. She was able to work as a teacher and managed her pain with regular chiropractic sessions and Pilates exercises.  But she was in severe pain most days.  Her significant medical history was that she had 2 operations as a toddler on her left eye to correct a squint.  She later had a very difficult labour and back-to-back pregnancy. Loading her tissues lead me to treat her head during the first session.  This brought an instant change to the symptoms in her left leg, which went away for the first time in 14 years!  Over the course of about 17 months she has attended about 10 times, as the need and the pressure of her other work and life commitments has dictated.  She now has absolutely no pain in her leg at all and still says that after 14 years, she finds it hard to believe. She does suffer occasionally from a degree of lower back pain and stiffness, but this is also easing as treatment continues.

Many people with pain that would be described as ‘sciatica’ may read this and identify with the symptoms experienced by these two patients. It is my hope that these brief summaries of two very different cases and the approach taken by Advanced Physiotherapy will give other people hope and a desire to keep seeking a cure for their pain.

As an experienced practitioner, I do recognise that some cases present themselves where full cure may not be possible – the reasons for which are too extensive to cover is this short blog - however, I never say never, I never think never, and I never do never!

As a child I was told; “where there is life... there is hope”, so I hope that this belief extends to you too!