Sciatica is when the sciatic nerve, which starts in your lower back and travels down the back of your leg into your feet, becomes inflamed. Sciatic pain can either be localised, producing pain and symptoms in your lower back and/or buttock or the symptoms can be more widespread and produce pain in your leg and / or foot. The pain most commonly affects one side, but symptoms can occur in both legs.

Can an Osteopath Help with Sciatica?

Sciatica is a common and debilitating complaint we see in our clinic and osteopathic treatment really can help relieve you of your symptoms. Our approach to treating sciatic pain using a hands on approach, combined with western acupuncture and exercise prescription allows us to get good, long lasting results for our patients.

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Different Types of Sciatica

The symptoms commonly related to sciatica are moderate or severe pain in the lower back, gluteal area and in the leg and foot. You may also be feeling pins and needles, a burning sensation and numbness in those areas as well. Most commonly, the symptoms affect one side but occasionally the pain and symptoms can affect both lower extremities.

Acute Sciatica

Acute sciatica is when the pain and symptoms have been present for 6 weeks or less. The severity of the symptoms can range from moderate to severe pain, as well as pins and needles, numbness, weakness and / or a burning sensation. These symptoms can affect the lumbar spine, gluteal area and the lower extremity.

Chronic Sciatica

Chronic sciatica – is when the pain and symptoms have been present for 3months or longer. The severity of the symptoms can range from moderate to severe pain, as well as pins and needles, numbness, weakness and / or a burning sensation. These symptoms can affect the lumbar spine, gluteal area and the lower extremity.

Bilateral Sciatica

Bilateral sciatica – Is when the symptoms affect both lower extremities at the same time. The symptoms, which can be the same as above, can vary in intensity from one side to the other, but both lower extremities are affected.

Alternating Sciatica

Alternating sciatica – Is when symptoms move from one side to the other, for example one day the left leg is most affected, then a few days later the symptoms have then moved and the right leg is then most affected. This can be unsettling for patients because the pain seemingly moves from one side to the other for no reason and it can be difficult to establish a pattern to the symptoms.

Wallet Sciatica

Wallet sciatica – Is a neuromuscular condition that can be caused by having a large wallet in your back pocket when you’re sitting down. The wallet can put pressure on the sciatic nerve as it travels between the gluteal muscles and the main muscle that can cause an issue is called Piriformis.

Causes of Sciatica

Sciatica can be a debilitating condition that can have a big impact on someone’s life. What is causing your pain and symptoms can vary, disc injuries, lumbar joint issues and hypertonic muscles are all possible structures that can produce irritation of the sciatic nerve. An osteopath can help you understand the cause of your symptoms, which is important because it allows for the treatment plan to be more specific and tailored to you. How long your symptoms have been present is also an important consideration. If pain has been present for 3+months, this is considered to be chronic and it could mean it may take longer for your body to respond to treatment.
Establishing the cause of your sciatic symptoms may require imaging to be done, such as an MRI. This is something your osteopath will be able to advise you on.

3D still showing Sciatica nerve
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Facet Joint – Spinal Pain

Our vertebrae are the bones that make up our spine and the joints that connect one vertebrae to the other are our facet joints (Zygapophyseal joints). The facet joints, along with the intervertebral discs help our spines transfer forces, as well as guide movement and motion and because of this it can predispose the facet joints to injury. Facet joint injuries can be acute causing sharp, sudden pain or more chronic and the symptoms can be localised or dispersed. The inflammation from around the facet joint can also cause muscle spasms and inflammation of the nerves, such as the sciatic nerve which may produce symptoms into the buttock, leg or foot. The facet joints can become symptomatic for a number of reasons such as stress and tension, poor posture, road traffic accidents and sports injuries.


Osteoarthritis can occur in any joint in the body and the symptoms can include pain and a reduced range of movement. These symptoms can vary from mild to severe but the pain doesn’t always correlate to the amount of tissue damage there is. As the symptoms of osteoarthritis often start gradually, other joints and muscles surrounding the arthritic joint can also become symptomatic and when this occurs in the spine, the nerves such as the sciatic nerve can become affected.

Disc Herniation

The intervertebral discs in the spine are made of shock absorbing fibrocartilage and sit between the vertebrae. They act like shock absorbing cushions which allow our spines to be strong and flexible structures that can absorb big forces. The nerves exit the spinal column through narrow openings which the discs help create and if the disc herniates it can place pressure on the surrounding nerve roots, which if this happens in your lower lumbar spine it can produce sciatica.

Piriformis Syndrome

This is a peripheral neuritis where the branches of the sciatic nerve become inflamed by the piriformis muscle. This can happen because of an injury such as a fall but often there is no apparent reason for the onset of symptoms. The symptoms are pain in the buttock area, but pain or nerve symptoms such as pins and needles or numbness may be felt in the leg or into the foot.

A tattooed man having lower back pain - possibly sciatica

Treatment of Sciatica

Sciatica is a common issue that our osteopaths see in the clinic and it’s a condition we are used to treating and managing. Our main aim initially is for treatment to help make you more comfortable, both during the day and through the night. If you are struggling to sleep or stay asleep because of the pain, this is important to try and improve quickly, because the better you sleep, the more your body can repair and heal.
The osteopathic approach to sciatica varies on what the cause of your symptoms are, but often a combination of massage and joint articulation is used to help reduce inflammation, pain and improve mobility. Osteopaths also look at other areas of your body to see if they could be contributing to your sciatica and by working on these areas as well, it can help them function as optimally as possible. Western Acupuncture (dry needling) is a technique our osteopaths use and its aim is to release myofascial trigger points helping muscles relax, be less painful and improve their range of movement.
Our osteopaths will also advise you on the best exercises to help stretch and strengthen your lower back and leg muscles to help prevent you from reinjury.
Sciatica rarely results in surgery, but in some cases it may be required. This is often a last resort for the patient and we would recommend the patient exhausts all other treatment options before considering surgery.