Sciatica

Massage therapy is an effective way to relieve pain. A 2014 study even found that deep tissue massage may be as effective as nonsteroidal anti-inflammatory drugs for relieving low back pain, which can be a symptom of sciatica.

When it comes to sciatica, massage can help in two ways. Massage’s main benefit is soothing tense muscles. When your muscles are tense, they can put more pressure on your nerves, including your sciatic nerve. Massaging these tense muscles may help to reduce pressure on your sciatic nerve.

Soft tissue massage may also help to increase your pain threshold by stimulating the release of endorphins. Endorphins boost pleasure and relieve pain, causing an increased feeling of well-being. They are also released during sex, exercise, and eating.

There are several types of massage therapy. There isn’t much evidence that one type is more beneficial for sciatica pain than another, so choosing one comes down to personal preference. Here’s a look at some of the most common types.

Axial Sciatica

This point is really critical: because axial sciatica can be associated with spinal instability (which may well be made worse if we go powering in with indiscriminate deep work).

So in the treatment of Axial sciatica, our aim is simply to ease the whole-body tensing and guarding that goes with chronic pain – and of course, the stress that accompanies that pain.

We are not doing deep or focused work on the lumbar nerve roots themselves. If the problem is a disc problem, a spinal problem then disc compression may be needed so the client should be referred to a chiropractor or osteopath who is trained, qualified, and insured to do that compression.

Three of the main causes of Axial sciatica are:

1.A herniated disc (also known as slipped or prolapsed disc), puts pressure on the nerve causing sciatica symptoms.

2.The issue could also be age-related degeneration in the spine, degeneration of the bones and joints leading to degenerative disc disease which irritates a nerve root and causes sciatica.

3.Lumbar spinal stenosis can cause sciatica due to a narrowing of the spinal canal

All of these problems are to do with entrapment of the sciatic nerve within the spinal structure and this needs treatment from a medical doctor, chiropractor, or osteopath – it’s not something that we are going to fix by massage.

But we can, of course, address some of the muscle tightness in the rest of the body.

Deep tissue massage

A deep tissue massage is an aggressive form of massage that uses slow strokes and deep finger pressure to release tension from your muscles and connective tissues.

A 2014 clinical study found that a 30-minute session of deep tissue massage five days a week over two weeks was found to effectively treat low back pain, including sciatica.

Swedish massage

Swedish massage doesn’t use as much pressure as deep tissue massage. Instead, flowing, kneading movements are used to stimulate nerve endings in your connective tissue and increase blood flow. It also helps to release general tension and promote relaxation.

Neuromuscular massage

Neuromuscular massage uses advanced massage techniques that combine deep tissue pressure and friction to release contracted muscles and relieve tension.

Myofascial release

Myofascial release is a technique used to relieve pain that stems from your myofascial tissues — the tough membrane that surrounds and supports your muscles.

Trigger points, which are stiff, immovable areas within the myofascial tissues, cause pain and stiffness. Focused pressure and stretching on the trigger points help to reduce pain and stiffness.

Hot stone massage

The hot stone massage is used to promote relaxation and ease tense muscles. Heated stones are placed on specific parts of your body and may be held by the massage therapist while they use Swedish massage techniques.

If you’d like to give massage for sciatica a try, it’s important to choose a qualified massage therapist who has experience in treating sciatica symptoms.

The bottom line

Massage for sciatica won’t cure the underlying cause of your pain, but it can help to temporarily relieve your symptoms and improve your quality of life. Speak to your doctor about your symptoms before starting massage therapy to make sure it’s safe for you.

Appendicular Sciatica

By contrast, in Appendicular sciatica, both the root cause and our approach are different.

This is because, in Appendicular sciatica, it is usually soft tissue that traps the sciatic nerve.

It can be just as painful as axial sciatica, but it will respond to soft-tissue work.

Appendicular sciatica is characterized by increased pain from sitting, stepping up stairs or steep inclines, the direct pressure of sexual intercourse in women, or with resisted active external rotation of the femur.

Sometimes the muscular tightness that is to blame can be in the lower back or in the legs – and occasionally in the feet causing problems further up the body, but the big culprit is the piriformis muscle.

In some cases, someone whose bowel is distended due to severe constipation can experience sciatica as the bowel puts pressure on the nerve.

Piriformis syndrome is also a cause of sciatic pain. The pain experienced is due to the piriformis muscle compressing the sciatic nerve, such as while sitting in a car seat or running.

In the majority of cases, it is likely that the piriformis muscle has simply become too tight and this puts pressure on the sciatic nerve giving the symptoms of sciatica.

If sciatica arises from piriformis syndrome the symptoms will usually become worse after prolonged sitting, walking, or running but may feel better after lying down on the back.

There is some disagreement within the medical and bodywork world as to if piriformis syndrome can be called sciatica but we have a clear precedent going back to Yeoman’s definition from 1928 describing what we now know as ‘Piriformis Syndrome’ as the compression of the sciatic nerve by the piriformis muscle.

Nerve entrapment by the piriformis muscle is probably the most common cause of appendicular sciatica accounting for up to 70% of these cases and there are simple tests that can be done to establish if this is the case.

As ever if your client is in any doubt they should seek a full medical opinion, this test is only one of many which can be carried out for sciatica.

Start by asking your client to sit towards the edge of a chair and lift the affected leg with the knee bent, as far towards the chest as is comfortable.

If this increases the pain it indicates that the problem is more likely to be in the piriformis, or adjacent and connected muscle groups.

When this is the case then massage deeper work is indicated in order to release the muscle tension that is putting pressure on the nerve.