Patients often present with Sciatica – as it is something that either their GP has diagnosed or because it is in such common usage they have diagnosed themselves (if you google sciatica you get over 22 million results!). Although Sciatica does exist, I feel it is an overused term – and often used as a catch-all term for low back pain (see Low Back Pain section).

True Sciatica is a whole set of symptoms which can include pain, pins and needles or numbness (paraesthesia) or even strange sensations with descriptions like “I have hot water running down my leg” or “my leg doesn’t feel part of me”. In order to be Sciatica, your sciatic nerve has to be irritated and could cause any or all of these symptoms.

The sciatic nerve in nerve terms is huge – most nerves are tiny like cotton or spaghetti, but the sciatic nerve is big electric cable thickness, at stages as wide as your thumb. It exits the spine from between the vertebra (building blocks of your spine) and extends down the entire leg into the foot. When we talk of nerves we use a tree analogy, the spine being the trunk then nerves branch off and even send twigs to the muscles.

Causes of Sciatica are numerous, here are just a few:

• Muscle – one of the most common causes we see is your Sciatic nerve being irritated by a big hip muscle called Piriformis, this is sometimes called piriformis syndrome. The nerve interweaves through the muscle, the muscle tightens, and the nerve becomes irritated.

• Disc injury – this is where the intervertebral discs are either bulging (slightly pressing) or prolapsed (more significant). Discs don’t “slip”, this is an old fashioned and not very useful description which makes it sound like we can just pop them back into place; this cannot be done. This disc pressure can irritate the nerve.

• Spinal damage – this could be damage to the spine itself either by a defect we were born with like Spondylolisthesis (a defect in the vertebra), Osteoporosis (thinning of the bone) or arthritis.

Treatment is dependant upon the cause and this is why we consider it important to be accurate with our diagnosis and terminology. We would recommend you come in for an assessment and we can give you a diagnosis and together we can hopefully improve your situation, we can do some treatment and you can do some exercise – there may well be homework! As an example, if you look at our staying well page there are some exercises which could help.