Your spine is one of the strongest parts of your body. It is made of solid bony blocks (vertebrae) separated by discs (a bit like a jam donut with a firm outside and a squidgy inner part) that help to give it strength and flexibility. Strong ligaments reinforce it and large powerful muscles surround it, both help protect it.
Sciatica is the common term for pain that is felt in the leg along the course of the sciatic nerve at the back of the thigh and running down into the calf. There are several different causes of sciatica and it may start suddenly or come on gradually. It can be a continual dull ache or sudden sharp shooting pains. The pain may run evenly all the way down the leg or there may be certain spots where it is more intense, commonly in the buttock, behind the knee or around the ankle. At these points the sciatic nerve is closer to the surface. There may even be numbness or tingling in the area of pain.
The nerve leaves the spinal canal between the vertebrae and this can become compressed by a bulging disc, where some of the ‘jam oozes out of the donut’. This can happen with something as trivial as sneezing, but is often due to a build up of pressure on the disc due to poor posture or bad working positions.
A short period of rest usually allows the disc to settle before physiotherapy to get you mobile again. In severe cases you may need to have an epidural injection to reduce the pain or even surgery to remove the part of the disc that is pressing on the nerve.
The joints between the vertebrae can lock up, often after gardening, which can then cause irritation of the sciatic nerve because they do not move properly. A short course of physiotherapy consisting of mobilisation or manipulation of the immobile joints can usually sort this out very quickly.
As people get older they may suffer from osteoarthritis or degeneration of the discs and vertebrae. This can cause back pain and may also irritate the nerve. Pain-killers and anti-inflammatory tablets may help, there is a natural anti-inflammatory called Serra Enzyme, along with electrotherapy or acupuncture for pain relief. You should also be given a simple series of exercises that will help you to manage your symptoms in the long term.
Sometimes you may experience similar symptoms to sciatica that may be coming from tight muscles in the buttock region or from the hip or sacro-iliac joint. A physiotherapist will assess your symptoms and give you the appropriate advice and treatment for your individual problem.