Sciatic pain is usually caused by the sciatic nerve being encroached (pressed) upon by one or more structures, which commonly include disc bulges, the priformis muscle or stenosis caused by extra bony or osteophytic growths around the exit points of the nerve from the spinal canal. Although the pain experienced by patients suffering from sciatica can be very acute and extremely uncomfortable osteopathy, in many instances, has been seen to provide relief and allow such patients to reach a state of relative comfort.
Disc injuries and related pain, unfortunately, are also fairly common occurrences. The disc consists of a gel like nucleus pulposus surrounded by a more fibrous annulus. The nucleus acts as a shock absorber while the annulus works with the facet joints to limit the range of movement of the spine – when this relationship breaks down injuries are more likely to occur.
Minor strains to the annulus are seen a lot and respond well to treatment and appropriate care. Disc herniations are far more debilitating and tend to cause substantial amounts of pain, but with patience and consistent treatment osteopaths are able to work with their patients to stabilise the injury and allow a good amount of function to return. A couple of years ago in the BSO clinic my colleague and I saw a gentleman who had disc herniations between three of his lumbar vertebrae and had lost the disc space completely in the remaining two. Every week he would hobble in, hardly able to walk and by the end of the treatment he would walk out as if hardly in any pain at all. In this case and with osteopathic treatment this patient found he was able to carry on doing the things he enjoyed.
Loss of disc space (known as spondolytic change) is also common, especially in patients above 40-45 years of age. This is a natural progression, where wear and tear on the disc and surrounding joints mean that the general health of the tissues reduces and in some cases lead to minor injuries or muscular spasms occurring in order to protect the area and prevent further injury.