Many of my patients at one time or another have mentioned to me that they have or do suffer with sciatica, but what does this mean? Of course logic would dictate that the sciatic nerve would be involved, but how and why does this nerve, of all the nerves in the body, cause so many people so much trouble. Lets find out…


The Sciatic nerve is a very large nerve that starts in the low back (being created by five smaller nerves leaving the spine),which then travels through the the pelvis, into the buttocks and then runs down the backs of the legs. At its largest the nerve is roughly the same thickness as your thumb, making it the largest nerve in the body.


Sciatica is a set of symptoms including pain that may be caused by general compression and/or irritation of one of five nerve roots that give rise to the sciatic nerve, or by compression or irritation of the sciatic nerve itself. The pain can be felt in the lower back, buttock, and/or various parts of the leg and foot, with predominance to the back of the leg. In addition to pain, which can be severe, there may be numbness, muscular weakness, and difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body, apart from in some severe cases. Although sciatica is a relatively common form of low back pain and leg pain, the true meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than a medical diagnosis for what is truly causing the symptoms.. This point is important, because treatment for sciatica or sciatic symptoms will often be different, depending upon the underlying cause of the compression. So, the correct diagnosis of the cause of your pain is of paramount importance to your overall management and recovery.


Here are a few of the more common causes osteopaths, such as myself, see in clinic;


Disc prolapse or herniation (slipped disc)– this compression happens in the spine when the fluid centre of the disc escapes and puts pressure on the nerve as it leaves the spinal cord. Pain is often marked in the back of the legs and will often last for many months.


Arthritis in the spine – as the spine gets older it is normal to see signs of wear and tear, however the changes occuring can cause the holes that the nerves leave through to reduce in size, which increases the likelihood of compression. Although the arthritis is not reversible, corrective treatment can drastically reduce the pressure in the affected area and will often relieve even the most severe symptoms.


Piriformis compression – this is a muscle in the buttock which when tight can cause pressure on the nerve giving nagging leg pain. It can occur due to long periods of stretch or in response to joint aggravation.


Sacroiliac joint problems– these are two very large joints between the pelvis and the spine which can become locked or painful producing muscle spasm and difficulty with particular movements. Females are particularly prone to this around pregnancy due to wieght and hormone changes.


Trigger points – are points in muscles that mimick pain caused by a nerve. This is not true sciatic compression at all. When muscles are tight for long periods they start to suffer with a lack of oxygen as blood is unable to enter them. This causes pain, which can often radiate all the way to the foot, even if the muscle in question is located in the buttock. This type of pain is very easily treatable using massage and other techniques to increase blood flow.


These examples are only a few of the more common causes of “sciatica” and help to outline that in many cases this term is incorrectly used. The only way to be sure of the cause of your pain is to have a trained medical practitioner, such as myself, assess the area in question and this will allow treatment to be specific for your complaint.


For more information on osteopathy or treatment at Bingham Osteopathic Clinic please call me, Tristan Hill B.Ost, on 01949 839 238, e-mail, or visit



Tristan Hill B.Ost