By Katura Lambright

Can massage help sciatica nerve pain: What causes it, and what is the solution for it?

Let’s begin by saying sciatic nerve pain can be one of the most debilitating pains humans experience. If you have ever been an unfortunate victim of this commonly known, easily treatable condition, you know this to be true. People look for a solution to sciatica in many and varied treatments. Some through alternative medicine, stretching, exercise, physical therapy, massage, and others through drugs, or even more drastic measures, such as surgery.

To understand how to treat this condition, one must understand the sciatic nerve’s primary function and general anatomy. The nerve exits from the lumbar spine, down the posterior leg all the way into the toes. This main nerve serves as the connection to the central nervous system for a good portion of the skin on the leg, posterior thigh muscles, as well as the muscles in the leg and foot. It would be fair to say that without this vital nerve, which in some spots can be as thick as a man’s thumb, we would have little to no function of our legs. One can’t help but wonder if perhaps because of it’s sheer size, and how quickly affected it can be by its surroundings, this very well may be where the phrase, “You get on my nerves” originates from.

“So what causes sciatica?” you ask.

The answer is relatively simple, yet the cause varies from person to person. There are six main reasons, which I will outline below. While some of the treatments are things you can do for yourself at home, always be sure to consult your physician first to make sure you are diagnosed correctly with your particular cause for sciatica. Your doctor may recommend that you do some stretches at home, and see a physical therapist or massage therapist as the best route for professional help.
The number one cause is bulging or herniated spinal discs. Discs are the soft spongy cushion between our spinal vertebrae, which allow us the free flowing movement of the vertebral column, and serve as an exciting point for nerves from the central nervous system. One may easily see how through the wear and tear of life when spinal vertebrae begin compressing the discs, the sciatic nerve easily impinges, and the communication from the central nervous system to the leg is partially or entirely kinked. However, herniated discs are worse than only a bulging disc, which is bad enough. The reason for that is because the disc material itself contains acidic components which are very irritating to the delicate nerves. It can lead to increased inflammation, therefore more severe pain, numbness, tingling, and muscle weakness. Whether herniated or bulging discs, the symptoms for both are exasperated with sitting or bending.

The second leading cause of sciatica is Lumbar Spinal Stenosis. This is a condition found mostly affecting older adults. This situation happens typically when there is a narrowing of the bony foramen that the lumbar nerves pass through. Arthritis is a major culprit for this narrowing of the foramen through calcium deposits and inflammation, hence compression of the of the nerves, once again. Also if spinal stenosis is the cause of sciatica, the condition is typically aggravated by walking.

The third cause for sciatica is Spondylolistheses. This condition is characterized by one vertebra slipping into an anterior position as compared to the adjacent vertebrae. This condition is classified as a developmental problem and is typically present at birth. While this is a condition that the author of this article has been diagnosed with, it is in its mild stages and through regular massage therapy and chiropractic care, it has improved in the last eleven years since the diagnosis. While my pain was only localized to the lumbar and gluteal region on account of this condition, it is not uncommon for others with this same condition, left undiagnosed and untreated, to experience more severe pain and even numbness and to tingle down the leg.

The fourth leading cause of sciatica is trauma, such as slips and falls, motor vehicle accidents, and sports. These external forces to the lumbar or sacral spine place direct pressure on the nerve roots. Depending on the force of the impact, it may permanently damage a nerve. Once again remember that it is important for you to see your physician to receive the proper diagnosis so you may be well informed of what type of recovery you can expect.

The fifth leading cause of sciatica is Piriformis syndrome. As a student of medical massage therapy myself, I am well aware that this is the one cause of sciatica that can be effectively treated by a well-trained medical massage therapist. The piriformis muscle lies almost directly perpendicular to the sciatic nerve. It is found deep to the gluteal muscles and attaches from the anterior surface of the sacrum to the superior aspect of the greater trochanter of the femur. Piriformis syndrome is simply the piriformis muscle compressing the sciatic nerve through one form or another of it being injured or overworked, and therefore pulled taut over the sciatic nerve.

The sixth and last cause of sciatica I will cover is spinal tumors. While these are rare and can be either benign or malignant, they can certainly be the cause of sciatica, if they are creating a compression of the sciatic nerve. Like I mentioned before, it is essential that you consult your physician so that you may receive an accurate diagnosis, for you can get the appropriate treatment.

Now how do we as medical massage therapists treat these conditions that are causing all this pain and discomfort for our client’s? Glad you asked because you have come to the right place for answers. I can’t stress enough the importance of a proper diagnosis must be attained before beginning treatment. Obviously, with a bulging or herniated disc, there are muscles that are attributing to the compression the discs are causing. However massaging, soft tissue release, (STR) and stretching may be used by a well-trained therapist. Particular care has to be taken to not stretch or massage beyond the comfort of the client, so no further injury is incurred. Therefore you should not let any random individual massage you, nor should you try stretches at home, without being under the direction of a professional, who is experienced in the varies times that can safely be performed. The other common causes of sciatica, that we have discussed previously, spinal stenosis, spondylolistheses, and piriformis syndrome may be treated in the similar manner outlined for herniated or bulging discs. Obviously, treatment will be on a case by case basis. The last two causes of sciatica, trauma, and spinal tumors are localized contraindications for massage, STR and stretching until cleared by a physician.
My hope and desire for any sciatica sufferer that may read this article are for you to find hope and know that you to can find so much relief for whatever your particular sciatica cause is when you find the right professionals, such as physical therapists and my personal favorite, medical massage therapists.