Sciatica

The sciatic nerve is a nerve of the lower limb (one on the right and one on the left).

Before seeing it in more detail we must return to its origin.

What is its origin ?

 

It comes from the sacral plexus which is formed at the level of the L4/L5 vertebrae (4th and 5th lumbar) and S1/S2/S3 (vertebrae of the sacrum). The sacral plexus in its course then presents 5 different nerve branches:

• Nerve of the piriformis muscle
• Nerve of the superior gluteal muscle
• Small sciatic nerve
• Nerve of the quadratus femoris and inferior gastrocnemius muscles
• Nerve of the obturator internus and superior gastrocnemius muscle

Its terminal branch will be the sciatic nerve which descends into the buttock then to the back of the thigh.

 

Arriving at the knee, the sciatic nerve divides into two branches: the common peroneal nerve and the posterior tibial nerve.

• The common peroneal nerve runs down the outer part of the leg at the level of the fibula.
• The posterior tibial nerve runs down the back of the leg, the heel, and the outer edge of the foot.

 

The sciatic nerve is both motor and sensory:

• Motor: it allows flexion of the leg and extension of the foot
• Sensitive: it allows sensitivity of the posterolateral part of the leg as well as the entire foot.

It is defined by pain in the lower limb located along the path of the sciatic nerve when it is compressed or irritated at one of its roots or along its path. This can be accompanied by lower back pain, we then speak of lumbosciatica.

 

What are the symptoms of sciatica ?

• The pain differs depending on the root affected.
• Pain often triggered by effort.
• Pain amplified when sitting, during episodes of coughing, sneezing.
• Tingling.
• Numbness.
• Loss of sensitivity and/or strength.

 

What are the causes ?

• Herniated disc: The pain is due to compression of one of the roots of the sciatic nerve associated with its inflammation. Conversely, the presence of a herniated disc is not always associated with lower back sciatica.

• Narrowing of the lumbar canal: due to osteoarthritis in the lumbar region, elderly people are most often affected by this pathology.

• Facet syndrome: facet joints are joints placed on either side of each vertebra. Prolonged bad posture or a violent false movement can cause blockage of the facets, leading to the onset of sciatica.

• Piriformis syndrome: the piriformis is a muscle located at the back of the pelvis which, once swollen, can exert compression on the sciatic nerve and irritate it.

• By shocks and trauma such as falls from a bicycle, stairs or even a car accident. Trauma can affect the roots of the sciatic nerve.

• Pregnancy: pregnant women are particularly affected due to physiological and mechanical changes (increase in the mass of the uterus, softening of the ligaments). It happens that these changes create pain in the lower back, sacrum or sciatic nerve.

 

 

Osteopathy to treat and prevent.

 

Osteopathy being a first-line medicine, the osteopath will carry out a history and a complete physical examination to ensure that your sciatica does not require prior medical treatment.

During his physical examination, the practitioner will determine the areas which may be the cause of your sciatica.

 

• The lumbar vertebrae: these can be blocked and therefore cause irritation of the sciatic nerve. Through his techniques, the osteopath will restore mobility to the lower back in order to reduce inflammation of the sciatic nerve.
• The piriformis muscle: when this muscle is too contracted it causes compression of the nerve. The osteopath can determine the origin of this contracture and treat it so that the muscle no longer compresses the nerve.
• The organs of the small pelvis: the osteopath using visceral techniques can improve the mobility of the organs of the small pelvis such as the bladder or the uterus which can lead to compression of the sciatic nerve.

However, the origin of sciatica can be distant from the pain (cervical, skull). The human body being a whole and whose structures can influence each other.

 

 

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