The sciatic nerve is the largest nerve of your body. What a lot of people do not realize is that the sciatic nerve is roughly about the width of your thumb (about 1 inch thick) and starts in the lower back. This nerve is actually a bundle of 3 nerves which begins at the L4/S3 segment of your sacral plexus (a collection of nerves fibers that emerge from the sacral part of the spinal cord). Those fibers unite to form a single nerve just in front of the piriformis muscle, which is a hip flexor that is located under all 3 of your gluteal muscles.
The problem with such a large nerve passing under a muscle that is located deep within the hip region is that most people don't really know how to treat it. Often, they seek the help of chiropractors, spine specialists, and physical therapists, while massage therapy is overlooked. When done properly, massage therapy can be just as effective as physical therapy and chiropractic, if not more so.
People will often try different things like sitting on a La Cross ball, or foam roll; practices which may offer temporary relief, or may exacerbate their symptoms. Without proper knowledge of the muscles involved in releasing the nerve it is certainly possible to cause injury if not careful.
When sciatica symptoms are present it can be excruciatingly painful, or just an annoyance more than anything, so everyone can suffer in different ways. Sciatica effects about 30% of people and about 5% of those folks can be affected on both sides of the body. With such a large amount of people being afflicted with this condition, chances are good that either you or someone you know is suffering from Sciatica-related pain at this very moment.
Many massage therapists and physical therapists might stick their elbow into the glutes to compress the piriformis muscle in an effort to get the muscle to let go. This treatment is very painful and unfortunately fails to result in relief of patient suffering. There may be a level of tenderness and discomfort, but the good news is that the more times you get treatment for Sciatica, the less discomfort you will feel while being worked on. Eventually, you'll begin to feel truly amazing, as the pain slowly melts away.
At Back in Balance Massage & Bodyworks, the techniques used to alleviate the symptoms of sciatica blend the tools and tricks of massage with those of physical therapy. The trick is to activate the muscle while stretching it out while our clients simply relax on the massage table and let it happen.
Problems with the Piriformis
Pain and discomfort in the piriformis muscle doesn't just occur in our clients with Sciatica. In fact, it is pretty much problematic for just about everyone who might experience lower back tightness or discomfort. Much of what we experience during our everyday lives is an aggravator for the piriformis muscle.
When we sit or stand for long periods of time, the weight of our torso is bearing down onto the hips bunching the muscles in the butt, including the hip flexor muscles. When the piriformis gets tight, it will pull your hips back which will cause you to have pressure and soreness right around where the spine inserts into the pelvis. The piriformis will not only twist the pelvis in whichever direction it is being pulled more, but it can twist the spine in that direction all the way up to the neck causing tightness between the shoulder blades and up into the neck. This may result in headaches for those afflicted.
Runners are prone to getting sciatica due to the fact they overwork their piriformis muscle. Typically they fail to make time for adequate self care or stretching in their routine, and problems can develop over time. People who sit all day will experience similar symptoms due to the body being forced into a seated position which puts the hips into their most relaxed state.
Then we have the weight of the upper half of the body literally pushing the hips down, and when we stand or walk for long periods of time on hard cement surfaces, it also will affect how the hips feel and function. In reality, no one is safe from experiencing sciatica and related symptoms to some degree.
Is Surgery the Answer?
For some people, the pain which they experience may be so severe that they seek serious medical intervention (surgery) to see if that can help them. They might also try less invasive, but still drastic measures such as cortisone shots and/or epidurals. These are typically temporary forms of relief which also come with recovery time and/or side effects one might not be expecting.
Surgery is expensive, both financially and physically. Radiofrequency ablation, or nerve ablation uses a heat probe to sever the nerve causing the pain signals to the brain. The probe is inserted into the spine using X-rays to guide it. Nerve ablation is a temporary form of relief however as the nerve will eventually repair itself, and sometimes, the pain can return with greater strength and frequency than before.
Many of our clients at Back in Balance Massage & Bodyworks experience pain down their legs. They often ask us if we know what causes dull aches in the low back and shooting pain down the leg. With confidence, we can tell them exactly what is going on and how we can approach their care and recovery over time using focused massage therapy techniques.
The problem is so many people will view massage as just a luxury. Others simply don't feel comfortable having a stranger touch them. These are the folks who are missing out on the benefits of massage therapy and the possibility of reducing their sciatica symptoms without needing to resort to surgical procedures.
However, some of our clients may have other issues which are actually more of a bone related than a muscular one and those typically will require surgery. Bone spurs can cause sciatic discomfort and people will generally need to have some sort of surgery to correct the issue. In the meantime and prior to those surgeries deemed necessary, massage therapy can help to keep those specific muscles relaxed so that the muscles aren't too stiff for the surgeons as well.
Unfortunately massage therapy often gets overlooked as a solution to sciatica relief because, truth be told, not many therapists have the confidence, knowledge, or technique required for doing the treatment that is necessary to give the clients maximum relief with the least amount of recovery time. Chiropractors will always tell you that they can help with sciatica (and to some extent I am sure they can), but not when the main problem is muscular. Physical therapists can be hit or miss with their knowledge of the piriformis muscle as well, and their experience (or lack thereof) could help or harm your already aching body.
Can Massage Therapy Really Help?
The technique developed by Back in Balance Massage & Bodyworks is a blend of Physical Therapy stretches modified with massage therapy strokes that perfectly melt the piriformis muscle giving you the release from the symptoms almost immediately. If the symptoms you suffer from are chronic, we recommend that you seek regularly scheduled treatments at least every 2 to 3 weeks until you are completely free of your pain. At that point, you would switch over to once a month to maintain progress.
A good massage is so much more than just a reward or something that you treat yourself to once a year. Our bodies are amazing machines that are able to recover, regenerate, and heal most problems, but without being proactive, they will break down on us sooner than they should.
People who get relief of their sciatica symptoms truly live with a higher quality of life. The symptoms of sciatica are not only painful and make everything uncomfortable, for some, but they can become debilitating. No matter which category you fall under Back in Balance Massage & Bodyworks can help! We're here to serve you, and help you take back your life!
Written by Rachel Weidemann
April 12th, 2017