Sciatica and How Therapeutic Massage Helps Relieve the Pain

Let me start off by setting the ground rules for my blog here.

1. Massage is never a one size fits all

2. The point of massage for sciatica is for pain relief

3. Massage alone cannot “fix” sciatica, it takes work on the clients end

4. This is based on my 6 years of experience treating a variety of lower back issues, including sciatica with anecdotal evidence, not actually measurable (unfortunately the biggest scientific reason of the lack research in our field)

So, let us begin, what the hell is Sciatica?

Sciatica occurs when the sciatic nerve in your lower back and gluteal region becomes compressed or irritated.  It usually affects one side of the body.  The longer it is untreated, the further down the leg the nerve pain goes.

How does Sciatica occur?

Well, it can happen from a variety of factors.  Disc herniation, bulging discs, bone spurs, spinal stenosis and even tumors can all allow a person to feel sciatic pain. 

Sciatic Pain usually occurs due to poor posture, which can lead to an imbalance of muscles, sitting for too long, bending at the lower back instead of using our legs, and added weight or pressure in the lumbar area while lifting, lunging, bending or sitting with too much weight distributed onto it.  It does not mean you are “overweight” and that losing weight is the cure all.  It can help, but hearing just that from a doctor is not usually fair to clients.

How can massage help?

The role of the massage therapist is a challenging one.  Unfortunately, it is hard to know without an MRI or X-Ray, what we are walking into with the client's body.  I always recommend my clients have an X-Ray and MRI scan completed prior to sessions. Typically, someone with sciatica presents with any or multiples of these: anterior pelvic tilt (both or just one side even), elevated pelvis on one side, tight psoas, tight quadratus lumborum, gluteal tightness, glutes not activating upon hip extensions, piriformis tightness, and fascial restrictions.

So, we will attempt to release all the above’s pressure on your body.  We will analyze all that you are presenting with, work on that area, work above, below and also the antagonists or opposite muscles.  There is a lot involved when working to relieve sciatica. 

The muscles to be worked on include amongst others: Erector Spinae Group, Quadratus Lumborum, Tensor Fascia Latae, Glute Maximus, Medius and Minimus, all hamstrings, all quads, psoas, Iliacus, Piriformis, and the surrounding fascia. 

Throughout the session, as always, the client has every right to tell a therapist that something hurts.  Our job is to do no harm.  If something hurts, we stop, and find another way to heal the body.  Typically the most pain will be felt when a therapist is on the QL, Glutes, psoas, and TFL.  If it is uncomfortable, it is normal.  But, if we are creating more pain, we need to know and change our approach.

Before, During and After the session we will discuss exactly what I felt, exactly what I did and why.  And we will also discuss what you can do in the meantime to help heal you between sessions.

What can you do when not receiving massages?

Move.  Best and easiest answer.   Move “correctly” is better still.  Staying seated all day is a major cause of sciatica. So, get up and move often. The more you sit, the more potentially irritated the nerve will be.

I cannot prescribe activities or exercises as I am not a doctor.  If I were to, that would be outside of my scope of practice.  HOWEVER, I would be comfortable enough to say, most physical therapy exercises my clients have been given, that have worked, include a variety of hip mobility exercises.  What I have seen work with my clients over the past six years includes “salsa-dancing”, glute activation exercises, PSOAS stretches and releases, and gate opener/closer exercises with glutes activated. Again, all hip mobility exercises. Stop if you feel pain.

I have also seen clients benefit from simply laying on the floor with their legs on a higher surface like a chair, knees bent to ninety degrees. This can help decompress the spine in the back. Again, stop if you feel pain.

I would also recommend having proper footwear, not sitting on our wallets or anything in your pockets, and most importantly, sitting on your ischial tuberosities, not your butt!

The ischial tuberosity is also known as the “Sit Bone” because we are supposed to sit on it. Every time you sit down and lean back and slouch, it is a recipe for lower back pain and likely, over time, sciatic nerve pain. 

Booking Sessions for Sciatic Nerve Pain Relief

Feel free to do your own research on the effects massage can have on sciatica.  These muscles above will come up again and again.  Every client should know what they are feeling and if you need any help understanding it, send an email or call or text me and ask! Happy to help!

First thing to do is to get out of pain.  Massage can help that. One massage will not “cure” it, but many sessions and constant movement in the right patterns, sitting in the right position, strengthening muscles in the right areas, and stretching muscles that need to be stretched, all can help fix sciatica without need for medications, injections or surgeries.  Your body is designed to heal itself, you just need to learn how to do so and get a plan in place!  

I would recommend having a massage therapist, personal trainer, and physical therapist all available to help you heal yourself!