Sciatica

Sciatica refers to pain that is felt along the sciatic nerve, which runs from the lower back through the buttock and down the leg.

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It is not a medical condition on its own, but a symptom that can arise from irritation or sensitivity in the lower back or surrounding structures.

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Common causes include changes in the lumbar spine, muscular tension, or mechanical irritation affecting nerve pathways.

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In many cases, symptoms fluctuate depending on position, movement, load and overall sensitivity of the nervous system.

People with sciatica often describe:

• pain in the lower back, buttock or leg

• sharp, burning or shooting pain down the leg

• tingling or pins and needles

• numbness or altered sensation

• pain that worsens with sitting or bending

• symptoms on one side of the body

• discomfort when standing or walking for long periods

• fluctuating symptoms depending on activity

Sciatica can develop for a range of reasons and often involves more than one contributing factor.

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Common patterns we see include:

• disc related irritation in the lower back

• mechanical compression or sensitisation of nerve structures

• prolonged sitting or static postures

• repetitive bending or lifting

• reduced spinal and hip mobility

• muscular tension in the lower back or pelvis

• previous episodes of back pain

• changes in load or activity levels

 

In many cases, symptoms are influenced not only by structure but also by how sensitive the nervous system has become over time.

Treatment is based on your individual presentation and may involve osteopathy, acupuncture and rehabilitation exercises.

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We treat the person in front of us, not just the symptom label.

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Often sciatica is influenced by a combination of mechanical factors, movement patterns and nervous system sensitivity rather than a single clear cause.

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From this understanding, treatment may aim to:

• reduce mechanical irritation

• improve movement and load tolerance

• reduce muscular tension in the lower back and pelvis

• support nervous system regulation

• gradually restore confidence in movement

 

Rehabilitation exercises are often included where appropriate to support recovery and reduce recurrence.

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This approach aligns with contemporary understanding that chronic low back pain is often multifactorial and benefits from individualised and function focused management rather than purely symptom based care (Hartvigsen et al., 2018; Foster et al., 2018).

Structural osteopathy focuses on improving how the body moves and distributes load.

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Treatment may include work on:

• lumbar spine mobility

• pelvic and hip function

• muscular tension in the lower back and glutes

• movement patterns and load distribution

• areas of restriction contributing to symptoms

 

Treatment uses hands on techniques designed to improve movement efficiency and reduce mechanical strain. Treatment often works best when combined with simple rehabilitation exercises to support the changes made during treatment (NICE, 2016; Qaseem et al., 2017).

 

Manual therapy techniques such as spinal mobilisation and manipulation may provide small to moderate short term improvements in pain and function for chronic low back pain, particularly when combined with exercise (Rubinstein et al., 2019; Coulter et al., 2018).

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Traditional acupuncture is used to support pain regulation and tension patterns associated with sciatica.

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It may help with:

• reducing pain sensitivity

• easing muscular tension in the lower back and pelvis

• supporting nervous system regulation

• improving overall comfort and relaxation

• assisting recovery in persistent or fluctuating symptoms

 

Evidence suggests acupuncture may provide modest short term improvements in chronic low back pain compared with usual care or sham procedures, although responses vary between individuals (Chou et al., 2017; Vickers et al., 2018; Furlan et al., 2005).

 

As with manual therapy, it is generally considered an adjunct within a broader rehabilitation approach rather than a stand alone treatment (NICE, 2016).

Rehabilitation plays an important role in many cases of sciatica.

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The aim is not aggressive exercise, but gradual and appropriate movement based on your current tolerance.

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This may include:

• gentle mobility work for the lower back and hips

• guided movement strategies to reduce irritation

• gradual strengthening where appropriate

• building confidence in sitting, walking and bending

 

Exercises are always tailored and progressed based on how your symptoms respond

Often the most effective approach combines osteopathy, acupuncture and rehabilitation.

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This allows us to:

• address mechanical contributors

• support nervous system sensitivity

• improve movement tolerance

• reduce recurrence of symptoms

 

Treatment is adjusted based on response rather than a fixed protocol.

Your first appointment includes:

• detailed discussion of your symptoms and history

• assessment of movement and function

• testing of contributing patterns

• hands on osteopathy and or acupuncture

• rehabilitation exercises or movement guidance where appropriate

 

Everything is tailored to your presentation on the day.

This approach may be suitable if you:

• experience sciatic pain down the leg

• have lower back pain associated with leg symptoms

• experience tingling or nerve related symptoms

• have pain aggravated by sitting or bending

• are recovering from a flare up

• prefer a hands on and individualised approach

• want integrated treatment and rehabilitation support

Recovery varies depending on:

• duration of symptoms

• severity and sensitivity

• activity levels and daily load

• how your body responds to treatment

 

Some people notice improvement relatively quickly, while longer standing or more sensitive cases require a gradual approach.

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Clear expectations are usually refined after assessment.