Understanding Sciatica: What It Is, What Causes It, and How We Can Help

Sciatica is a term many of us have heard, often used to describe pain that radiates down the leg. But what exactly is sciatica? And how does it differ from other types of nerve pain?
What Is Sciatica?Technically, sciatica refers to irritation or compression of the sciatic nerve, the largest nerve in the body. This nerve originates from the lower spinal nerve roots (L4 to S3), travels through the buttocks, and runs down the back of each leg. When it’s compressed or irritated, you might feel pain, tingling, numbness, or weakness anywhere along that pathway.
However, in everyday language—even among healthcare professionals—the term sciatica is often used more broadly. It's commonly applied to any lower back or buttock pain that radiates into the outside of the thigh and sometimes further down the leg, even when the true source of the problem lies in the spinal nerve roots rather than the sciatic nerve itself.
This brings us to an important distinction:

• Sciatic nerve irritation occurs along the course of the sciatic nerve, usually in the buttock or thigh.
• Nerve root irritation (sometimes called radiculopathy) occurs at the level of the spine, often due to a disc bulge, spinal stenosis, or inflammation affecting the nerve roots as they exit the spinal canal.

Despite this difference, both conditions can produce very similar symptoms—so in practice, we often just refer to them collectively as “sciatica.”
Common SymptomsSciatica symptoms can vary in intensity and location, but they typically include:

• Sharp, burning, or shooting pain radiating from the lower back or buttock down the leg
• Numbness or tingling along the same pathway
• Muscle weakness, particularly in the leg or foot
• Pain that worsens with sitting, coughing, or certain movements

Symptoms usually affect one side of the body and may come and go or persist chronically.
What Causes Sciatica or Nerve Root Irritation?There are several ways the sciatic nerve or its roots can be irritated:

• Herniated disc: A common cause where disc material presses on a nerve root.
• Degenerative disc disease or spinal arthritis: These can narrow the spinal canal (spinal stenosis), compressing nerve roots.
• Muscle tightness: The piriformis muscle in the buttock can irritate the sciatic nerve (piriformis syndrome).  A tight hip flexor can also press on the nerve at the pelvic brim.
• Trauma or repetitive strain: Can inflame or irritate tissues surrounding the nerve.
• Postural issues and poor biomechanics: Long-term habits that put strain on the lower back and pelvis.

How We Can Help.  A multi-modal, personalized approach can offer significant relief and long-term improvement:

• Osteopathic Manipulative Therapy (OMT)OMT uses gentle, hands-on techniques to improve spinal mobility, relieve muscle tension, and restore proper alignment. By reducing mechanical strain on the nerve roots and surrounding tissues, OMT can help reduce inflammation and improve nerve function.
• Exercise and RehabilitationTargeted exercises strengthen the core, improve spinal stability, and promote flexibility in the hips and legs. A tailored rehab program also retrains posture and movement patterns to prevent recurrence. For many patients, this is key to long-term recovery.
• Medical acupuncture can help by reducing muscle spasm, improving blood flow, and calming nerve irritation. It can be particularly helpful when used alongside manual therapy and exercise.

When to Watch for Red FlagsWhile most cases of sciatica are treatable with conservative care, certain signs may indicate a more serious underlying condition. Seek immediate medical attention if you experience:

• Loss of bladder or bowel control
• Significant weakness in the leg or foot
• Numbness in the saddle area (around the inner thighs or buttocks)
• Unexplained weight loss or fever
• Pain following significant trauma or injury

These symptoms may suggest conditions like cauda equina syndrome, spinal infection, or a tumor—and require urgent evaluation.  We would recommend attenting your local accident and emergency unit  immediately .
 
In Summary
Sciatica is a common condition that can significantly affect quality of life, whether it stems from the sciatic nerve itself or the spinal nerve roots. Fortunately, with a combination of osteopathic manipulative therapy, personalized exercise, and medical acupuncture, we can often reduce symptoms, restore function, and prevent recurrence. If you're experiencing leg pain or nerve-related symptoms, don’t wait—early assessment and treatment can make all the difference.

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