What is Sciatica?
The sciatic nerve is the longest nerve in the body and sciatica is an umbrella term given to any sort of pain that is caused by irritation or compression of the sciatic nerve.
Symptoms include leg pain, sometimes accompanied by tingling, numbness, or weakness.
It originates in the lower back and travels through the buttock and down the large sciatic nerve behind the thigh and the pain can radiate down below the knee.
Sciatica is not a diagnosis in itself, it is instead a symptom of an underlying problem.
There are two main types of sciatica and knowing the difference is important.
1. ‘Axial’ sciatica is where the nerve root has impinged at the lumbar spine
2. ‘Appendicular’ sciatica is where the nerve entrapment is elsewhere in the nerve, not in the nerve
- 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. …
- Swedish massage. …
- Neuromuscular massage. …
- Myofascial release. …
- Sit on the floor with your legs stretched out straight in front of you.
- Bend your right leg, putting your right ankle on top of the left knee.
- Lean forward and allow your upper body to reach toward your thigh.
- Hold for 15 to 30 seconds. …
- Repeat on the other side.
What is sciatica?
Sciatica is the term used to refer to pain along the sciatic nerve, which extends from your lower back, through your hips and buttocks, and down each leg.
Sciatica typically affects only one side of your body and can range in severity from mild to severe. It’s often accompanied by other symptoms, including numbness, tingling, or weakness in the affected leg and foot.
Sciatica can interfere with your daily activities and make standing, walking, and even sitting difficult. If you’d like to try an alternative to traditional painkillers, massage may be able to help. It won’t treat the underlying cause of your sciatica, but it may provide some temporary relief from pain.
Read on to learn more about the potential benefits of massage for sciatica and how to try it yourself.
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.
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 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 uses advanced massage techniques that combine deep tissue pressure and friction to release contracted muscles and relieve tension.
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.
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.
Massage Treatments for Sciatica
It is important to differentiate what type of sciatica you are dealing with in order to treat it correctly.
If you are in any doubt, err on the side of caution and work with the simpler and gentler treatment given for Axial Sciatica.
How we treat sciatica depends on the cause of that sciatica. If the problem is a disc problem then disc compression is needed so the client should be referred to a chiropractor or osteopath who is trained, qualified, and insured to do that compression and we are only going to do more general work, leaving the area immediately around the spine alone.
1. Massage is completely contraindicated if any of the following symptoms accompany sciatica: • weight loss or any loss of control of the bladder or bowel, the person should seek emergency medical treatment • if the pain is too severe for self-management • If the client has sudden, severe pain in their low back or leg and numbness or muscle weakness in the leg or legs.
2. If the symptoms have come on instantly after bend or stretch, where the person they can’t stand up straight or can’t walk and also gets sciatica symptoms, the sciatica is secondary to the main problem in the spine and the person needs referring to a doctor, chiropractor or osteopath for a full diagnosis and to treat the primary spinal problem. If after that treatment the sciatic pain remains, then it may be appropriate to do massage work in consultation with their spinal specialist.
3. If during your massage the pain or symptoms increases rather than decrease, then stop your treatment and refer the client to their doctor.
4. If the client has had a history of cancer within the last five years, particularly bone, sarcoma or pelvic or bowel cancer ask them to get their doctor’s consent for treatment around the spine, sacrum, and hips.
5. Other, more rare, causes of sciatica include; irritation of the nerve from adjacent bone, tumors, internal bleeding, infections, injury, and for some women, pregnancy. If in doubt – get a medical opinion.
What is Deep Tissue Massage and what to expect?
Deep tissue massage is a massage that is designed to get into the connective tissue of the body, rather than just the surface muscles. As a massage therapist when I perform deep tissue I use a variety of techniques to deeply penetrate the muscles and fascia, loosening them and releasing tension. Most clients have a more intense experience with a deep tissue massage, but also feel that it is more beneficial because it addresses deep-seated muscle pains. Deep tissue is beneficial when undertaken on a regular basis so that I can work together with the client to correct long term problems, relax the body, and prevent injury.
To get a truly good deep tissue massage you need to find someone who specializes in deep tissue, like Nicola. Most spas have several massage therapists who can offer a basic deep tissue massage integrating a number of techniques and styles customized for your body for maximum impact. Experiment by trying several deep tissue massage therapists to find the one that is the right fit for you and your body.
One of the defining differences between deep tissue and regular massage is the use of tools. A standard massage usually only involves the hands and lower arms of the therapist. During a deep tissue, however, I use elbows and fingers for deep, penetrating work in the muscle. A deep tissue massage also tends to be very slow, and I will use long, flowing strokes to ease in and out of the muscle. Going in too quickly can cause the muscle to tense up, which is not the desired reaction. I also maintain firm pressure at trouble spots for several minutes to achieve muscle release before moving on to the next area of the body.
Deep tissue massage is designed to relieve severe tension in the muscle and the connective tissue or fascia. This type of massage focuses on the muscles located below the surface of the top muscles. Deep tissue massage is often recommended for individuals who experience consistent pain, are involved in heavy physical activity, such as athletes, and patients who have sustained physical injury. It is also not uncommon for receivers of Deep Tissue Massage to have their pain replaced with a new muscle ache for a day or two. Deep tissue work varies greatly. What one calls deep tissue another will call light. When receiving deep tissue work it is important to communicate what you are feeling.
When you go to get a deep tissue massage, you should talk with the therapist about any issues you might have and like to see addressed during your massage. I am happy to concentrate on a single body part for an entire massage to achieve lasting results and in fact, half of my clients want just that! It is also important to communicate with me about pain; The massage may be intense, but if a client starts to feel pain, he or she should communicate that immediately. I work on a scale of 1 – 10, where 7 is on your comfortability edge for that day and 10 is very uncomfortable pain. A lot of my clients take the deep tissue pain or even like the pain in order to get the quickest results for their body type. At the end of the session, lots of water should be consumed to help the body express the toxins released during the massage. You will probably be sore for a few days after the intense deep tissue treatment but that’s normal. Remember that ice is your friend.
*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
The information provided is for educational purposes only and is not intended as diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader. These statements are not expressions of legal opinion relative to the scope of practice, medical diagnosis, or medical advice, nor do they represent an endorsement of any product, company, or specific massage therapy technique, modality, or approach. All trademarks, registered trademarks, brand names, registered brand names, logos, and company logos referenced in this post are the property of their owners.