Massage for Sciatic Nerve Pain

A new client came to Sea Breeze this week, presenting with the classic signs of sciatic nerve pain.

If you’ve ever experienced sciatica yourself you will know exactly what I’m talking about – a pain, usually on one side of the body only, which travels from the lower back, through the buttock and down the back or the side of the leg.  Sciatica can range in intensity from weakness, numbness, tingling or a mild pain through to out and out excruciating agony. The pain is often lessened when the person bends forwards and is felt more intensely when walking, coughing or sneezing.

What Causes Sciatic Nerve Pain?

Symptoms of sciatica occur when the sciatic nerve is irritated or compressed. The sciatic nerve is the largest single nerve in the body, and starts in the lumbar (lower) region of the back, branching out from the spinal cord down the back and side of the leg.

A number of conditions can give rise to sciatica:

• A herniated (or ‘slipped’ disc) putting pressure on the nerve
• Piriformis syndrome; the piriformis is the pizza slice-shaped muscle which lies deep within the buttocks. If it becomes tight or inflamed it can irritate the nerve
• Spinal stenosis; when the spinal canal narrows, putting pressure on the nerve
• Spondylolisthesis; when a vertebrae slips out of position, putting pressure on the nerve

Other causes include infection or injury to the spine, a growth in the spine (such as a tumour) and the rare but serious condition cauda equina syndrome. Sciata is often experienced during pregnancy, due to the growing baby putting pressure on the sciatic nerve.

In most cases of sciatica the person will recover within around six weeks, but in more extreme cases surgery may become necessary.

How Can Massage Help?

I tend to approach cases of sciatic nerve pain with caution. It’s vitally important to take a full personal history from the client and assess each person on a case by case basis. Sometimes massage will be appropriate and can help, other times it could the make the situation much, much worse (for example, where a herniated disc is involved).

As part of the consultation process I start off by trying to get an accurate description of the type of pain and its pathway, any relevant medical history, the person’s lifestyle and exercise choices, how the pain first started and what steps they have already taken to relieve the pain. It’s always advisable to ask the client to approach their GP first, to ascertain any contraindications (reasons to not massage).

I find it can be helpful to use heat to warm tight muscles before working on them - this also makes the treatment much more pleasurable for the client! A range of massage techniques can be employed on the muscles of the lower back to free any tightness, especially those around the hip and spine, before moving onto the gluteals and piriformis deep within the buttock.  There is usually a 'trigger point' (tight spot of knotty muscles) in the piriformis and if the client can bear it, sustained pressure on this point can encourage blood flow and a lessening of the tension and pain. The other area I like to work on is the back of the legs, the hamstrings in particular, as this is the path that the sciatic nerve (and therefore the pain) takes.

Self-Help

Finally, I like to offer some home-care exercises that will gently stretch the piriformis, glutes and hamstrings.  There's a really great video here which provides some lovely yoga stretches - why not give them a go!