Sciatica is commonly used to describe lower back and leg pain while true sciatica extends down the back or posterior aspect of the thigh and can extend beyond the knee, through the lower leg and foot. The sciatic nerve is the large nerve which comes out from the lower part of the spine.

It takes branches from the part of the spinal cord which is surrounded by the lower spinal vertebrae, the lumbar vertebrae. The lower back does a lot of work throughout its lifetime and is subject to wear and tear in an increasingly inactive and stressed population, prone to injury. But the good news is that it is generally repairable. Most patients turn up with acute or severe pain. Initially most of the pain is caused by the swelling or inflammation around the area but, fear not, this will subside. Remember: wound healing and repair hurts. It's important that we do not add to the existing complaint by stressing too much about the outcome. Bodies heal if you seek a bit of help, rest and don't allow yourself to become too anxious or frightened. This only results in more tension and slower healing.

The advent of MRI scans allows us to see the condition of the spine but not always the site of injury. Many consultants now suspect that MRIs exaggerate the importance of old or burnt out injuries, frightening the patient more and repeating the cycle of fear stress, tension and slower repair.

Pain killers are still too readily prescribed although I'm glad to see this practice is dying out; taking pain killers and resting can help but taking pain killers and soldiering on usually doesn't. It's no good masking the symptoms and will only result in you over doing it. Manual therapy works and is safe. It's always better to explore the least drastic option first, that is, gentle osteopathic treatment.

Our approach is to fire-fight to begin with. In a few weeks you should be feeling better and then it's always good to deal with the causes at some point. You don't want to keep re-injuring yourself so we specialise in back strengthening and rehab.

It takes a bit of effort, but it works.