Sciatic pain is a common affliction caused by compression or irritation of the sciatic nerve. The sciatic nerve is a significant one, as it innervates the entire skin covering the leg, the muscles of the back, thigh, leg and foot. When irritated, it produces a set of symptoms, including pain, known as sciatica.
Sciatica can occur from any of the following conditions:
- disc herniation;
- degenerative disc disease;
- sacroiliac joint dysfunction;
- piriformis syndrome;
- facet joint problems;
- lumbar spinal stenosis.
Occasionally, individuals can also suffer sciatica after suffering from other health complaints, such as excessive coughing, muscular hypertension or even sneezing.
Symptoms of sciatica
Sufferers of sciatica can report lower back pain, buttock pain and numbness, weakness or pain in various parts of the lower limbs, pins and needles sensation or difficulty coordinating or moving the affected limb. Some people experience unrelenting pain with sciatica while others find that certain positions, such as sitting, exacerbate their pain. Pain is usually felt on one side of the body.
The sciatic nerve (also known to as the ischiatic nerve) originates from the lower back, from L4 to the S3 segments of the sacral plexus, which is a collection of nerve fibres that emerge from the sacral part of the spinal cord. The nerve travels through the pelvis and becomes one nerve, where it sits in front of the piriformis muscle. It then passes to the rear of the piriformis (in the buttocks), through the pelvis, down the lower limb and ends at the back of the foot – making it the longest nerve in the body.
“Sciatica is a set of symptoms, not a diagnosis for what is causing
Massage for relief of sciatic pain
Sciatica may be relieved by massage. However, it is important to understand that sciatica is a set of symptoms, not a diagnosis for what is causing the irritation of the nerve root. Therefore, it would be incorrect to say that sciatica is a disease that can be cured or always helped by massage. Relief will always depend on what is causing, or contributing to the cause of the condition. Each patient presenting with sciatic pain must only be treated after a comprehensive assessment to understand the causes of the individual’s condition.
For example, if disc herniation causes the sciatic pain, it may take six weeks for the disc herniation to subside before relief is longer lasting. Treatment before that time may only provide short-lived, symptomatic relief.
If an individual is suffering from sciatica because of generalised compression of the lower back – for example, tight quadratus lumborum (QL), tight psoas, tight glutes – due to a lack of flexibility, then massage therapy will provide a more positive response, with longer lasting benefits. Once the client is ‘loosened up’ by a few massage therapy sessions, hopefully she or he can continue with a stretching and exercise program to further free up the area and reduce flare-ups.
It’s important that all muscles of the lower back are relaxed and balanced to avoid compression of any of the five spinal nerve roots of each sciatic nerve. Important muscles of this region include:
- the QL – sits vertically in the lower back;
- the piriformis – sits diagonally in the gluteal region;
- the iliopsoas – a large muscle that connects from the lower back through to the front of the thigh;
- the quadratus femoris – located at the back of the leg;
- the gluteals – located at the rear of the pelvis – also known as buttock muscles.
Suggested maintenance exercises
With sciatic pain, it is essential to educate clients on the importance of self-care. Following a massage session, depending on the individual’s pathology, the following suggestions may be helpful to prevent future episodes of sciatic pain:
- learn self-massage techniques, such as lying on a roller, or using a rubber ball on the floor or against a wall to massage tight areas;
- maintaining adequate levels of hydration – pain can be exacerbated when the body is dehydrated;
- lifestyle and ergonomic changes – avoid sitting for long periods, address issues regarding office chairs, lounge chairs and mattresses;
- maintaining a regular stretching program;
- maintaining a regular overall exercise program to strengthen postural muscles, keep weight at a healthy level and keep emotional stress, a key cause of nerve pain, at bay.
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