We all get low back aches and sprains from time to time; and these are usually very well resolved by good osteopathic care. However, when this is combined with leg pain it can be much harder to sort out.
Is it a disk?
Disc injuries do happen, but they are actually rare: specially in patientsover forty. It is normal for soft shock absorbers to bulge. So most of the scans and suggestions of surgery are mistaken. The medical view is much too narrowly focused to give a true picture. The broader osteopathic diagnosis looks at all of the anatomy with it’s function; and is far more integrative.
Most back with leg pains involve a wide combination of muscular, joint and ligament distortions. The muscles commonly torsioned may spread round serratus posterior inferior, quadratus lumborum, multifidus, the glutei, quadratus femoris and the piriformis. The lumbar facet joints, ilio-lumbar and sacro-iliac ligaments are often also in trouble.
This syndrome with back and leg symptoms we see all the time, and responds very well to slow easing treatment. It may include all of the above tissues, but most frequently the inward rotation of the hip is restricted by muscular over bracing and responds to slow careful stretch and release.
Is it Sciatica?
Any symptoms down the back of the leg to the foot can be called sciatica. The sciatic nerve can be impinged anywhere along it’s course; including by the piriformis muscle. The most serious sciatica happens when a lumbar disc is torn and ruptured in younger people. This can give a true nerve root compression; and in the most severe cases may require surgery: but this is rare. Conservative management gets most of them out of trouble.
Arthritis and Stenosis
From about 55 onwards we all know that the wheels begin to fall off! The wears and tears of life repair much slower and poorly as we grow old. These damage the spinal joints and hips with arthritic changes, and eventually narrow the spinal canal and nerve exits in the very old. This “stenosis” is often hard to manage.
Late Recovery Patterns
Injuries, seizures and worn parts may have been present for many months or years. Restoring fuller function can initially make these “sleeping dogs” very sore and tired for a while. But persistence in better function nearly always pays off --- so don’t despair. Happily the body’s recuperative capacities can be remarkable at any age once the obstacles are removed.