Patients often come for a massage expressing pain they are experiencing with sciatica.
How patients describe the pain they are experiencing:
- They are referring to sensation that is going down the leg, normally the back of the leg, but sometimes the side or even coming around to the front.
- Sometimes the pain starts in the low back, often it’s from the buttock area.
- Occasionally the pain is only experienced in the lower leg.
True sciatica and its causes
True sciatica is when the sciatic nerve is compressed by other structures, usually a muscle or joint.
I have observed that there is commonly a misalignment of the hips in these cases, this is usually associated with a tight or weak piriformis, often with trigger points present. Because a joint has muscles creating force from all angles, a tight piriformis is often paired with a tight TFL or other hip flexor muscle, such as psoas. These paired muscles can be either on the same hip or sometimes they are working diagonally across the body so the front of one hip, and the back of the other is tighter.
The sciatic nerve often runs underneath the piriformis or sometimes through it, so when the muscle fibres of this hip rotator muscle hold tight they can compromise the nerve and create the pain response. When this pattern of muscular dis-ease is present it can also cause the bones of the sacroiliac joint or the lumbosacral joints to come closer together or to articulate at an angle that is not ideal for clean mechanical movements. The pressure on the nerves can, in turn, cause the muscles of the buttocks, hips and low back to spasm, which can then cause further distress to nerves and a feedback loop is created. The vertebra of the low back can then be drawn at an angle, again causing the paths of nerves to be compromised.
How Sports massage can help with sciatica
Applying neuromuscular techniques to the trigger points to encourage the hyperactivity in the muscle to calm can reduce the pain in the muscle. It can reduce the tonicity, in turn relieving the pressure on the nerve and also allowing the various joints to move more freely.
However, there are some precautions to take:
Caution must be taken, however, if the muscles are splinting as they may be protecting nerves from being compressed further if a vertebral joint is not stable. If a patient is expressing a resting pain of over 8/10 then ideally a chiropractor/osteopath or the GP should examine the client to diagnose or refer for x-rays or scans and then recommend what treatment is best.
If you suffer from sciatica and want to know more information, book an appointment with one of our Sports Massage Therapist, we’d love to help you!
