The treatment of sciatica is complex as the signs and symptoms of this condition associated with sciatic nerve irritation can be caused by a variety of causes. In most cases, an experienced healthcare professional will be able to recognise the signs and symptoms of sciatica and will recommend medical imaging (X-ray and/or MRI) which will be necessary to establish a clear diagnosis and to enable the exact cause of the sciatica to be treated.


What is sciatica?


Sciatica describes symptoms associated with pain that originates in the lower back and radiates down the leg. It is not a diagnosis per se, but rather a symptom of an underlying lower back problem, such as a herniated disc, bulging disc, degenerative disc disease (e.g., pinched disc), spondylolisthesis, or spinal stenosis.


Sciatica usually accompanies lower back pain, but can be more severe and can occur on its own. Therefore, hip or knee pain does not necessarily mean that there is a condition causing the pain there: it may indeed be caused by a pinching or irritation of the sciatic nerve that causes this pain to radiate away from its point of origin.




Sciatica and its 46 synonyms


Numerous synonyms (46) for sciatica; a very sharp pain which, fixing on the path of the sciatic nerve, occupies the posterior part of the thigh and leg; are found in the scientific literature as follows

  1. Osteoarthritis with sciatica
  2. Sciatic nerve damage
  3. Disc bulge with sciatica
  4. Burn of the sciatic nerve
  5. Disc disease with sciatica
  6. Pain in the thigh
  7. Pain in the buttock
  8. Pain in the leg
  9. Sciatic nerve pain
  10. Pain on the underside of the foot
  11. Pain in the heel
  12. Numbness of the sciatic nerve
  13. Sciatic hernia
  14. Herniated disc with sciatica
  15. Ilio-sciatica
  16. Sciatic nerve injury
  17. Injury to the external popliteal nerve
  18. Injury to the medial popliteal nerve
  19. Lumbago with sciatica
  20. Lumbosciatica
  21. Lumbosciatica
  22. Ischiatic nerve
  23. Sciatic nerve
  24. Great sciatic nerve
  25. Small sciatic nerve
  26. External popliteal sciatic nerve
  27. Medial popliteal sciatic nerve
  28. Sciatic nerve neuropathy
  29. External popliteal sciatic nerve neuropathy
  30. Neuropathy of the medial popliteal nerve
  31. Sciatic nerve neuralgia
  32. Sciatica neuralgia
  33. Bilateral sciatic nerve neuralgia
  34. Sciatic nerve neuritis
  35. Sciatic neuritis
  36. Sciatic nerve paralysis
  37. Pinched disc with sciatica
  38. Pinching of the sciatic nerve
  39. Sacro-sciatic
  40. Sciatica
  41. Bilateral sciatica
  42. Bilateral sciatica
  43. Sciatica with lumbago
  44. Sciatica due to intervertebral disc disease
  45. Stenosis with sciatica
  46. Lumbosacral root syndrome


What are the symptoms of sciatica?


  1. Severe pain that can make it difficult to stand or walk
  2. Constant pain in only one side of the buttock or leg (rarely in both legs except in the case of central disc herniation)
  3. Pain that is worse when you are sitting
  4. Pain radiating down the leg and sometimes into the foot and toes (rarely only in the foot)
  5. Leg pain that is often described as burning, tingling or tightness
  6. Weakness, numbness, or difficulty moving legs, feet, and/or toes
  7. Although the symptoms can be painful and potentially debilitating. Permanent damage to the sciatic nerve is rare and involvement of the spinal cord is possible but rare.
  8. Sciatica pain can range from rare and irritating to constant and disabling.


What is the sciatic nerve?


The sciatic nerve is the largest nerve in the body and is made up of nerve roots that originate in the lumbar region of the spine and then combine further down to form the "sciatic nerve". Symptoms occur when the great sciatic nerve is irritated or compressed at or near its point of origin.


What is the path of the sciatic nerve?


  1. The pain or symptoms (numbness, tension, heaviness, burning, weakness) follow the path of the sciatic nerve, which originates in the lumbar region of the lumbar spine (e.g. L5-S1) and runs down the leg through:
    • The middle part of the buttock,
    • The posterior aspect of the thigh,
    • The back of the leg (calf),
    • The heel and sole of the foot and the toes.
  2. The pathway may be incomplete, i.e. you may experience pain or symptoms all along the sciatic nerve or only in one part (e.g. pain only in the calf). This will depend mainly on how the nerve is pinched or irritated.

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How does sciatica manifest itself?


  1. Sciatica rarely occurs before the age of 20 and becomes more common in middle age: it is most likely to develop around the age of 40 or 50.
  2. Perhaps because the term sciatica is often used to loosely describe leg pain, estimates of its prevalence vary considerably. Some researchers have estimated that it will affect up to 43% of the population at any given time.
  3. Sciatica is often not caused by an event or injury but rather tends to develop over time.
  4. The vast majority of people who suffer from sciatica will feel better in a few weeks or months and get relief from their pain with non-surgical treatments such as manipulation or neuro-vertebral decompression. For others, however, sciatica pain can be severe and debilitating.
  5. It is advisable to consult a doctor if you suffer from sciatica pain, not only to learn how to relieve the pain but also to check for the possibility of a more serious medical problem such as a herniated disc.


Who suffers from sciatica?


There are no exact data on the incidence and prevalence of sciatica. In general, it is estimated that 5% to 10% of patients with low back pain have sciatica, while the lifetime prevalence of low back pain ranges from 49% to 70%. The annual prevalence of disc-related sciatica in the general population is estimated at 2.2%. Some personal and occupational risk factors for sciatica have been reported, including age (more common between 45 and 64 years), height (taller people suffer more), mental stress, smoking, strenuous physical activity (e.g. frequent lifting, especially bending and twisting) and exposure to vehicle vibration (including whole-body vibration). The evidence for an association between sciatica and gender or physical condition is conflicting.


The 25 causes of sciatica pain :


  1. Herniated disc (responsible in 90% of cases)
  2. Disc bulge
  3. Pinched discs
  4. Spinal stenosis
  5. Root stenosis
  6. Spondylolisthesis
  7. Piriformis syndrome
  8. Arthritis - Osteoarthritis
  9. Poor posture
  10. Sacroiliac joint dysfunction
  11. Joint dysfunction of a lumbar vertebra
  12. Misalignment of a lumbar vertebra
  13. Misalignment of the pelvis
  14. Sprain
  15. Muscle spasm
  16. Pregnancy
  17. Rapid weight gain
  18. Frequent wearing of high-heeled shoes
  19. Sitting for too long
  20. Sitting cross-legged
  21. Too much jogging on too hard a surface
  22. Repetitive work requiring lifting heavy objects in a twisting motion
  23. Aging
  24. Diabetes
  25. Tumour
  26. Infection
  27. Fracture


What is the best treatment for sciatica?


There is no single "miracle" treatment for sciatica pain, but many different treatments depending on the cause of the sciatica. And to determine the exact cause of your sciatica pain, X-rays or magnetic resonance imaging may be necessary. This will depend on your history, the presentation of your symptoms and the physical examination.


Treatment of sciatica by neurovertebral decompression


If the sciatica is caused by a disc problem (herniated disc, protrusion, bulging disc, pinched disc or desiccation) that can be diagnosed with a magnetic resonance imaging (MRI) or a computed tomography (CT) scan, or when it is due to stenosis or spondylolisthesis, neurovertebral decompression treatment is one of the most effective treatments.

However, if the neurological symptoms become too severe, such as loss of feeling or almost complete loss of mobility in the leg, these signs should not be ignored and urgent medical attention should be sought before irreversible damage occurs. Your condition may require surgery in the lumbar region of the spine.

To find out more about treating sciatica with neuro-spinal decompression, click here !


Treatment of sciatica with physiotherapy


When sciatica is caused by piriformis syndrome, or muscle spasm, physiotherapy treatment is very effective. In physiotherapy, an exercise programme incorporating a combination of strengthening, stretching and aerobic conditioning is a central part of sciatica treatment.


Osteopathic treatment of sciatica


In cases where sciatica is caused by arthritis, osteoarthritis, poor posture, sacroiliac joint dysfunction, lumbar vertebrae joint dysfunction, lumbar vertebrae misalignment, pelvic misalignment, sprain, or pregnancy, osteopathic treatment offers excellent results.