Sciatica & Osteopathy in Kyoto | OQ Clinic English

Sciatica & Leg Pain

The sciatic nerve is the longest nerve in the body, running from the lumbar spine through the buttock and down the leg to the foot. When it is irritated anywhere along this path, pain, numbness, or tingling follows the nerve’s distribution.

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The path of the sciatic nerve — symptoms follow the route

1. 1Lower backNerve roots leave the lumbar spine and sacrum.
2. 2ButtockThe roots join into one thick nerve, deep beneath the piriformis muscle.
3. 3Back of the thighIt runs down through the hamstrings.
4. 4Behind the kneeIt divides into two branches.
5. 5Calf & footThe branches continue down to the foot.

The Common Assumption — and Its Limits

“You have sciatica because of a disc herniation pressing on the nerve” is a common explanation. It is sometimes correct. But two important facts complicate this narrative:

1. Many people with disc herniation on MRI have no sciatic symptoms.
2. Many people with clear sciatic symptoms have normal MRI findings.

This means the disc is not always the whole story.

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The scan and the symptoms don’t always match

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Disc herniation on MRI

No sciatic symptoms

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Normal MRI

Clear sciatic symptoms

Both are common → the disc is not always the whole story

Other Causes Worth Investigating

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Beyond the disc — four other places to look

1. DLumbar discThe usual explanation — sometimes correct, but not the only one.
2. 1PiriformisA deep buttock muscle right beside the nerve; spasm here can compress it.
3. 2Pelvis & sacroiliac jointsUneven loading changes the tension around the nerve.
4. 3Pelvic organsIn women, uterine ligament tension or restricted organ mobility can follow the same distribution.
5. 4Posterior fascial chainSole → hamstrings → sacrum → lumbar fascia. Restriction anywhere along it can contribute.

Piriformis Syndrome

The piriformis muscle lies deep in the buttock, adjacent to (or passing through) the sciatic nerve in many people. Trigger points or spasm in this muscle can compress the nerve without any disc involvement.

Pelvic and Sacroiliac Dysfunction

Asymmetrical loading of the pelvis and sacrum changes the tension environment of the soft tissues around the nerve.

Visceral Referral

In women, uterine ligament tension or pelvic organ mobility restrictions can produce symptoms that follow the sciatic distribution.

Fascial Restriction

The posterior myofascial lines run from the sole of the foot through the hamstrings, across the sacrum, and into the lumbar fascia. Restriction anywhere along this chain can contribute to sciatic symptoms.

OQ’s Approach

We assess the whole mechanical and neural picture:

• Lumbar and sacral mobility
• Piriformis and deep hip rotator assessment
• Pelvic alignment
• Visceral mobility (where relevant)
• Gait pattern and lower limb biomechanics

Related pages

• First visit — what to expect
• What is osteopathy?
• OQ English top page