Lumbosciatica: Causes, Diagnosis, Treatment & Prevention – An interview with Dr. Silvia Francese
December 21, 2025 – Salute Of Editorial Team
This article addresses lumbosciatica (commonly known as sciatica), a frequent and debilitating condition affecting the lumbar spine. We spoke with Dr. Silvia Francese,an osteopath and physiotherapist with 20 years of experience treating skeletal pathologies and dysfunctions,to gain insights into this condition.
What is Sciatica and What are it’s Symptoms?
Dr. Francese explains that lumbosciatica,or lumbar radiculopathy,stems from irritation or compression of the sciatic nerve – the longest and most voluminous nerve in the human body. Originating in the lower lumbar spine, the nerve travels down the leg, through the buttock, thigh, knee, and calf, reaching the foot. Therefore, pain can radiate from the spine all the way to the heel.
Key symptoms include:
- Pain, frequently enough triggered by prolonged fixed positions.
- Pain exacerbated by coughing or sneezing.
- Tingling and numbness in the leg.
- Reduced muscle tone.
Spinal Dysfunctions and Sciatica
Several spinal issues can contribute to sciatica:
- Disc Disease: Degeneration of the intervertebral discs, which act as shock absorbers and allow spinal adaptability. This can lead to dehydration and vertebral arthrosis.
- Herniated Disc: Protrusion of the nucleus pulposus, compressing the sciatic nerve.
Dr. Francese emphasizes the importance of a correct differential diagnosis to rule out more serious conditions like spinal tumors, spinal canal stenosis, or spondylolisthesis.
Diagnosis: What Tests are Useful?
Modern diagnostic technologies provide accurate evaluations. Magnetic resonance imaging (MRI), computed tomography (CT) scans, and even simple X-rays can help analyze the spine and identify any dysfunctions.
When to See an Osteopath & Treatment Options
Osteopaths can intervene during the initial inflammatory (acute) phase. A specialist should first confirm the diagnosis through orthopedic and neurological tests, and potentially instrumental tests, to ensure the pain originates from a structural issue related to lumbosciatica.
Treatment can be administered alongside anti-inflammatory medication, but it’s preferable to wait approximately ten hours after taking corticosteroids before beginning treatment. Early intervention can reduce pain and accelerate recovery.
Preventing Sciatica Attacks
Prevention is key. Dr.Francese recommends:
- Balanced lifestyle: A healthy diet (like the mediterranean diet), regular physical activity, and adequate hydration (water at room temperature, potentially with added salts).
- Posture control: Maintaining good posture, especially during prolonged sitting (car, desk), to avoid spinal curvature alterations. Engage abdominal muscles.
- Supportive Mattress: Using a sufficiently firm mattress, replacing it every 10-15 years.
Increasing Incidence in Younger People
Dr. Francese notes a growing trend of younger individuals developing lumbosciatica, even chronic forms. Thus, preventative measures are crucial for all age groups.
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