Sciatic pain comes from your sciatic nerve that radiates from your lower back then into the back and the side of your legs. It can range from a mild ache to sharp and severe pain. You may experience numbness, tingling, or weakness in your leg or foot. Sciatic usually starts with a herniated disk in your lower spine. When a disk begins to get worn down, either because of an injury or just overuse its soft center can push out the hard-outer ring.
Note that the sciatic nerve is the longest in the body. Some risk factors can be age, weight, or diabetes. Most people who get sciatica are between 30-50 years old. For those that are overweight or pregnant have a more significant chance of getting a herniated disk. Diabetes can overall cause nerve damage. There are about three types of sciatic pain that come from different nerve roots. One comes from L-4 nerve root which will cause pain or numbness in the medial lower leg and foot; this may prevent the foot from bringing the foot upwards known as dorsiflexion.
The other sciatic pain comes from L-5 which causes weakness in the big toe and possibly the ankle as well. Last nerve root is S-1 which causes pain or numbness on the lateral or outside of the foot; this makes it difficult raising the heel off the ground or walking on your tiptoes. The best way to treat sciatic pain is to get a lower back, gluteal, and leg massage. You should never stretch around a pinched nerve, always work on the opposite side of the nerve entrapment, and for the first session only do effleurage on the affected side. You first begin in prone position meaning lying on your stomach and begin by warming up the muscles on the glute area and around the lower back slightly for about 2-3 minutes with your fists, so you’re able to reach the piriformis.
Once you reach their piriformis, you perform STR (soft tissue release) meaning you apply pressure to a trigger point, stretch, and then release. You should repeat both of those steps three times. After that begin making trigger points in the hamstrings with some compressions. You should work the Iliotibial band which is located on the lateral side of the thigh between the vastus lateral and biceps femoris.
Then start stretching adductors with the leg in a number 4 position. Also, perform STR while in the same four position. Begin hip and quad extension while locking the glute (for joint mobilization). Lift muscles off the calf by performing petrissage, work for the iliotibial band once again, soft tissue release on the tibial muscles with heel raising towards the glute, then as your in this position work between the 3 and four metatarsals on foot.
At this point you want your client to be in a supine position which is lying on back, face up. Begin working on the quadriceps group which includes rectus femoris, vastus lateral, vastus intermedius, and vastus medialis.
You should also work hip flexors, do straight leg raise as a stretch, hip circles, stretch adductors as well to end it off. Your client should get up from the table with no pain. Inform the client they may come back for more sessions every 1-2 weeks for the next 2-3 months depending on how bad it is and their schedule.
If you suffer from Sciatic Nerve PainCarpal Tunnel Syndrom, make an appointment with one of our therapist calling 610.670.1010