Sciatica is a term that's thrown around a lot, but it only applies when the sciatic nerve is the cause of the symptoms. This nerve forms within the pelvis from nerves that leave the spinal cord at the base of the spine. The nerve then runs down the back of the thigh, splitting at the knee. One branch runs down the shin, and the other goes to the sole of the foot via the calf.
Rather than a diagnosis, sciatica is really a collection of symptoms. There are a number of potential causes that should be investigated in order to develop a real diagnosis. When a nerve is irritated, a patient will often report:
Symptoms are typically focused very closely to the course of the nerve, to the extent that you may be able to map out the affected area with a marker pen. Other conditions that are often confused with sciatica usually cause a more vague spread of symptoms, which is one clue that the nerve itself might not be to blame.
Referred pain is a big consideration when a patient arrives with sciatica-type symptoms. If the pain is in the right area, but covers a broader space rather than a defined line, it is less likely to be a trapped nerve. Instead, it might be caused by the way the brain is interpreting a problem elsewhere. If a joint in the lower back or pelvis is irritated, it is not unusual for the brain to misinterpret it as leg pain. It sounds odd, but it's the same mechanism as people who feel arm or jaw pain in a heart attack, rather than chest pain. Understanding that the pain is actually nothing to do with the nerve means that treatment can be focused to the right area, and a change can be made more quickly.
A less surprising cause of thigh pain is a simple hamstring issue. The pain may be similar, and weakness would not be surprising, but pins and needles or numbness will not be present. There may be some bruising, and the history will not align with nerve pain.
Finally, pain that fits the description but not the location cannot be sciatica. It can, however, be the same mechanism affecting a different nerve. Shooting pain and pins and needles in a defined line along the front of the thigh could be a femoral nerve irritation, for example. Treatment and management would be similar depending on why the nerve was irritated in the first place.
Osteopathy can be effective in managing sciatica, but the appropriate course of action will depend on the root cause of the symptoms. Your history and the way your pain behaves will give your osteopath a good idea of where the nerve is being irritated. Some common causes are:
Alongside addressing issues with joints, discs, and muscles that might have caused the problem initially, we can help with the sensitive nerve. You might find that normal sensations are painful in the affected area, or pain is just heightened. Gentle exposure to stimuli can help to desensitise the nerve, and we can give you exercises to continue your progress between sessions.