Back pain, in particular lower back pain, sciatica and ‘trapped nerves’ are among the most common reasons adults seek osteopathic treatment. This is unsurprising, given that up to 80% of people will suffer from back pain in their lifetime (Walker, 2000).

The fact you are reading this, probably means you have personal experience of back pain or know someone who does. If so, don’t despair, there is plenty you can do to alleviate your pain and reduce the risk of reoccurrence.

There are many causes for back pain, but lifestyle is nearly always a significant factor. For example, if your job involves sitting at a computer all day or lots of driving, you are more likely to experience back or neck pain than other people. At the other end of the scale, a sudden increase or change in activity can also be bad for your back.

The thing we have less influence over is age. Incidence of back pain increases the older we get, due to normal age-related changes, such as gradual loss of disc elasticity and ‘wear and tear’ to spinal joints.

Lower Back Pain

While sometimes localised to the lower back, pain can also refer to the buttock, groin, leg and foot. It can be caused by injury or dysfunction of any of the structures in the lower back: discs, ligaments, muscles or joints. However, in reality there are often more than one of these involved. Below are the most common causes:

• Facet joint restrictions or injury (facet joints are the joints at the back of your spine between the vertebrae)
• Osteoarthritis and age-related spinal ‘wear and tear’ to joints and discs
• Disc herniation or prolapse
• Pelvic torsion affecting sacroiliac joint function
• Muscle strain and muscle imbalance
• Ligament sprain

Sciatica

‘Sciatica’ or ‘a trapped nerve’ describes symptoms in one or both legs originating from the sciatic nerve or its nerve roots. Symptoms usually only affect one side and include:

• Tingling or numbness in the leg or foot
• Sharp searing or burning pain down the back or side or the leg, often worse when sitting
• Weakness in the leg, ankle or foot
• These leg symptoms may or may not be accompanied by lower back pain

The sciatic nerve roots are located between the spinal vertebrae. They can be irritated or compressed by a disc herniation or prolapse, or from age-related arthritic bony growth which can irritate the nerve root as it exits from the spinal column.

The NHS recommends manual therapy (which includes osteopathy) for low back pain treatment (NICE, 2016). It can also help relieve related symptoms of sciatica. An osteopath will conduct a thorough assessment to to work out what is causing your pain and how best to treat it.

Osteopaths will usually (but not always) work on the symptomatic area of your back. However, they will also look beyond to other areas of restriction or dysfunction which may be contributing to the problem. Read more about osteopathic treatment.

Most back pain can be treated effectively with osteopathy. However, sometimes an osteopath may need to refer you to your GP for further tests or scans. This may be because symptoms are not improving or to rule out less common causes of back pain such as referred pain from conditions affecting internal organs.