What is a Sciatica? Sciatica refers to pain, weakness, numbness, or tingling along the sciatic nerve, which starts at the third lumbar vertebra in the lower back. The nerve passes behind the hip joint, along the buttock, down behind the leg to the foot. The sciatic nerve is the most extensive and longest nerve in your body. The term sciatica refers to the inflammation of that nerve.
Symptoms are usually felt in the lower back, into the buttock and down to the foot, following the path of the compressed sciatic nerve, problems with the spine is often the source of sciatic pain. When the spine is the source of sciatica, it bears the name of true sciatica. If the source of sciatica is not coming from the spine it is called a pseudo sciatica!In both cases, the symptoms are the same, pain and tingling in the lower back, into the buttock and along the leg to the foot. A tight fascia and/or trigger points in your glutes for example would mimic the symptoms of a sciatica!
We’re dealing with a true sciatica if the source of the pain comes from the spine. Your sciatic nerve could be stuck between two vertebrae or it could be an herniated disc that compresses the sciatic nerve.
A pseudo-sciatica is when the source of the pain does not involve the spine. Piriformis syndrome is undoubtedly the most common pseudo-sciatica. It can be easily mistaken with a true sciatica.
What is piriformis syndrome?
The piriformis is a muscle located in the buttock. The piriformis syndrome is when the muscle (piriformis) compresses the sciatic nerve caused by muscles contractions , fascia restriction, trigger points, thickening or inflammation of this nerve.
The Causes of Piriformis Syndrome!
The most common causes are:
- Sitting too long
- Myofascial pain and trigger points
- One leg shorter than the other
- Misalignment of the sacroiliac joint
- Congenital variation of the piriformis
- Carrying a wallet in the back pocket of your pants
So gentlemen, if you want to avoid suffering from piriformis syndrome, I advise you not to put your wallet in the back pocket of your pants. In order not to put pressure on your piriformis muscle, which in turn will press on your sciatic nerve. The nerve might be irritated by wearing a wallet. In addition, it is very bad for your posture while sitting.
There are different treatments to relieve sciatica. But which ones are most appropriate for your pain? I know you must ask yourself "Do I suffer from a true sciatica or piriformis syndrome?" So how do you know who should see for first. I have seen to many people coming to see me and told me they have chronic sciatica and after a treatment or two they feel so much better! After few years of practice and seeing many people complaining of sciatica pain, I personnaly believe that if you did not have any major accident , injuries or congenital anomalies the answer is..... you should see first a Licensed Massage Therapist!
You could always go see your family doctor and leave with a prescription of anti-inflammatory or steroid injection, but you will have treated the symptoms only and not the cause. So, why should you see first for a Licensed Massage Therapist? Let me explain!
Suppose that your sciatica is a pseudo-sciatica (Piriformis Syndrome) and you go see a massage therapist. I do not mean to go to a spa to get a relaxing massage, but to go see a massage therapist that does medical massages. The massage therapist will apply techniques to relax the muscles that may be involved in the piriformis syndrome. It is true that the piriformis muscle is the principal muscle involved, because it compresses the sciatic nerve, but there are also other muscles that are also involved such as the gluteus maximus and gluteus minimus. So during treatment the massage therapist will work to relax all these muscles. Massage is very effective for treating piriformis syndrome!
Most of the time what people call sciatica (pain in the butt) is piriformis syndrome and it can be easily treated by massage.
Now suppose you have a true sciatica (involvement of the vertebrae) and you see a massage therapist. It is true that the massage therapist can not manipulate the spine to release the sciatic nerve that may be stuck between the vertebrae, but he can relax, release tension even deactivate certain trigger points in the muscles. Yes! You will have a relief, but for a short time because it is a true sciatica. Yes! You’ll probably have go see a chiropractor or physician , the advantage in seeing a massage therapist first is that it will be easier for the chiropractor to adjust you after, plus the treatment will last longer because the muscles affected will be relaxed from the treatment given by the massage therapist.
Piriformis Syndrome Self -Treatment!
An excellent way to prolong the benefits of massage and to maintain healthy muscles between appointments is to perform self-care massage. I would recommend two excellent tools. I would recommend first of all the following book:
Learn the secrets to lasting pain relief: finding and deactivating trigger points, the underlying cause of most low back pain. Trigger points are sensitive tight spots in taut bands of muscle tissue. Treating trigger points that refer pain to the low back and buttock areas, rather than addressing only the specific sites of your pain, is the best way to comprehensively treat occasional or chronic discomfort and prevent it from coming back.
Packed with illustrated treatment techniques, Trigger Point Therapy for Low Back Pain offers effective strategies beginners can practice at home and detailed hands-on protocols health care practitioners can use while working with patients. Find out which of eleven muscles could be causing back pain, then learn specific trigger point treatments and correct underlying perpetuating factors to immediately relieve soreness and tension in these muscles. If you’re ready to try a targeted approach to eliminating back pain, this manual will provide you with all the information you need to get started and end low back discomfort once and for all.
The other tool that I recommend is the myo ball. The feeling of the myoball is amazing, firm and smooth enough to adapt easily to different part of your body and work theses trigger points.. I highly recommend them!
Thanks for reading!
Legal Disclaimer: The information provided on EnergyKinesiologist.Com is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions.You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
By: Michel Bourgeois, Licensed Massage Therapist & Energy Kinesiologist in Santa Monica