Osteopathy for Sciatica: A Non-invasive Holistic Approach

What is Sciatica?

Sciatica refers to the pain, weakness, tingling, or numbness that radiates along the path of the sciatic nerve, often caused by compression or irritation of the nerve or nerve roots along its pathway. The severity of sciatica varies from person to person and is caused by several different reasons. The Sciatic nerve begins in the lower back (lumbar) with nerve roots coming out between the 4th lumbar vertebrae to the 3rd sacral vertebrae, they merge into one large nerve traveling through the gluteal region and down the back of the leg. The nerve then splits into two different pathways near the knee to travel down the rest of the leg. 

Goal of Osteopathic Treatment 

Osteopathy is a holistic and hands-on approach to healthcare that can be effective in addressing sciatica and sciatica-like symptoms. Osteopathy treatment for sciatica aims to relieve these symptoms by addressing the underlying musculoskeletal or alignment issues and promoting the body’s natural ability to heal. Sciatica and like symptoms can arise from several different reasons therefore it is the Osteopathic Manual Practitioner’s goal to understand ‘why’ there is pain and how to work through the different layers of tissues to facilitate self-healing processes and ultimately prevent sciatica symptoms from occurring. When finding the root cause of the problem, the osteopath is not just masking the pain but getting to the actual cause in order to prevent it from coming back. Here’s how working with an Osteopathic Manual Practitioner can help with sciatica and like symptoms:

1. Comprehensive Assessment: The osteopath will begin by conducting a thorough health history intake assessment understanding the patient’s medical history, lifestyle, and physical conditions to identify any underlying causes for the pain such as diagnosed disc herniations, spinal stenosis, or muscle imbalances. 
2. Manual Therapy: Osteopathic treatment entails an individualized hands-on approach working through all layers and tissues of the body; superficial, intermediate, and deep. Gentle manipulation is applied by working with the body rather than against it to reduce any tensions/ misalignments and promote fluid flow, nerve connection, and muscle relaxation. Freeing any obstructions present allows for the body to function and heal itself optimally. 
3. Blood, Lymphatic and Nerve Flow: Osteopathy promotes better blood and lymph circulation throughout the body, which will ultimately assist the area of concern. This is important as the increase in healthy fluid flow will aid in the delivery of essential nutrients and oxygen as well as remove any toxins present without any obstruction. Freeing obstructions through the nervous system allows for optimal function of the nerves and reduces any compression or tension present within the nervous system. It is very important to take any compression or tension away from the area where the sciatic nerve runs to reduce sciatica and similar symptoms and allow that region to heal.  
4. Holistic & Non-invasive: Osteopathy considers the body as a whole, finding the root cause of the problem and not strictly looking at the site of pain. Other areas of the body may be contributing to the pain experienced therefore, assessment and treatment will entail the full body. Osteopathy is gentle and drug-free that is safe and effective. 
5. Education: After treatment, the patient is educated on what is going on in their body, creates an individualized osteopathic treatment plan, and encourages any specific stretches/ exercises. 

Sciatica can be very painful and impede the quality of life you live daily. Osteopathy offers a holistic and non-invasive approach to manage the symptoms. Through gentle manipulations, soft tissue techniques, and an individualized treatment plan, the osteopath aims to alleviate the pain and understand the root of the problem how it started, and how to prevent it from coming back. The osteopath facilitates an environment for the body to self-heal and self-regulate and allows the systems of the body to function optimally. 

Case Study 

The patient came in experiencing low back and hip pain on the right side with pain and tingling down through the gluteal region and down the back of the leg stopping halfway down the upper leg. It began 3 months ago after shoveling heavy snow and persisted while on vacation doing a lot of walking. The patient saw their medical doctor and it was confirmed it was sciatica they were experiencing. The pain was progressively getting worse and there were days that were so bad the patient had limited mobility. Different modalities of treatment did not relieve any pain or range of motion therefore, the patient outsourced Osteopathy treatment for sciatica to assist with the problem as they are finding household chores and other daily activities difficult to complete. The patient has medically diagnosed osteoarthritis found in the sacroiliac joints and lumbar spine and medically diagnosed bursitis on the right hip. The patient sits at a desk for work and experiences the most pain when seated or coming up after bending down to pick something up.

Through assessment and treatment osteopathically, the whole body was looked at for any asymmetries, motion restrictions, tissue texture changes, and sensorial changes. There was notable hip motion restriction and pelvis rotation, as well as alignment changes through the lumbar curve. The lumbar spine had a preference motion of flexion with compression on the right side of the curve being held by soft tissue such as the thoracolumbar fascia, erector spinal muscles, and quadratus lumborum muscle. There are also deeper tissues such as ligaments between the lumbar vertebrae that are influencing the mobility of the lumbar spine and the osteopathic lesion pattern. The left innominate was in a posterior position and the right innominate was in an anterior position putting tension on the hip flexors. The right sacroiliac joint was restricted in motion and the external rotator muscles of the hip such as the piriformis were in a shortened contraction. The thoracic curve globally had a motion preference of flexion and rotation to the right. The 11th thoracic vertebrae on the 12th thoracic vertebrae were flexed and had a motion preference to the right. The lower cervicals had motion preference to side bend left and rotate left and the whole body was in high sympathetic tone and palpable tension throughout the body. After one session the patient reported feeling good, sleeping much better and more comfortable and not taking as much medication. They still reported getting in and out of a chair or the car as a problem and sitting for long periods of time still uncomfortable. After the second session, they saw significant improvement getting in and out of the car, the pain is no longer travelling down the leg at all, and they can do their gardening and go for longer walks. After 5 osteopathic treatment sessions the patient has subjectively reported feeling much more mobile, pain is very infrequent, and it does not travel down the leg at all. The patient is now on a maintenance schedule to keep on top of their mobility, alignment, and balanced tissues and allow them to continue to do the things that they love to do pain-free. 
If you have been suffering from sciatica and wondering if Osteopathic treatment is for you? Be sure to book your free 15-minute consultation call or an Initial Osteopath Appointment with one of our osteopathic manual practitioners Jenna Labranche or Patrick Suwala. 

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