What Causes Sciatica and How Is It Assessed?
Updated: Sep 20
Sciatica describes pain and/or neurological symptoms from irritation of a nerve root in the lower back. It commonly affects one leg and may include tingling, numbness or weakness. Not all leg pain is sciatica.
What does this mean?
Disc change is a common cause, but narrowing around the nerve and other conditions can produce similar symptoms. Most cases improve without surgery, provided urgent neurological signs are absent.
How we would assess this at Ben Cohen Osteopathy
We start by listening to the history and understanding which everyday, work or sporting activities have changed. The examination is then selected to test the most likely explanation and important alternatives.
map leg symptoms and test strength, reflexes and sensation
use nerve-loading and spinal movement tests where appropriate
screen carefully for cauda equina syndrome and progressive deficit
Treatment and rehabilitation: practical examples
Treatment is individual rather than a standard sequence of techniques. Where osteopathy is appropriate, hands-on care may be used to help symptoms or movement, but the longer-term plan usually depends on progressive activity and rehabilitation.
find tolerable positions and keep activity within manageable limits
progress spinal and lower-limb exercise
refer for imaging or specialist opinion when weakness progresses or recovery is not following the expected course
What progress may look like
Progress is rarely perfectly linear. We would normally agree one or two functional markers—such as walking time, stairs, sleep, lifting, heel raises or return to training—and review whether capacity is improving. A temporary flare does not automatically mean damage, but a major or unexpected change should be reassessed.
When should you seek medical help?
new bladder or bowel disturbance, saddle numbness, bilateral severe symptoms or rapidly worsening weakness needs emergency assessment
Useful next steps
If you would like an individual assessment, book an appointment online at Loughton, South Woodford, Chigwell or Epping.
Frequently asked questions
Can osteopathy help?
It may help when examination supports a musculoskeletal diagnosis within an osteopath's scope. We will explain if another clinician, imaging or medical review is more appropriate.
Will I need a scan?
Often not. Imaging is most useful when it can answer a focused question and alter management. We will explain the reason if it is recommended.
How many appointments will I need?
That depends on the diagnosis, duration, goals and early response. We set a review point and avoid recommending treatment without a clear purpose.
This article provides general information and cannot diagnose an individual problem. Clinical recommendations depend on an appropriate history and examination.
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