Sciatica is low back pain that radiates down through the buttock and back of the leg, often on only one side of the body. It is due to impingement of the sciatic nerve, the largest nerve in the body. The sciatic nerve forms from nerve roots in the lumbar spine, your low back. There are two sciatic nerves, one for each leg, and they travel down through the buttocks and the back of the leg to your feet.
The nerve can be compressed or pinched in the spine or further down the length of the nerve. Conditions such as a herniated vertebral disk, spinal arthritis, uneven pressure on the vertebrae from imbalanced muscles or other disease conditions in the spine can narrow the space around the nerve, causing swelling, pain and irritation. However, often the symptoms of sciatica are caused by muscle impingement, specifically by the piriformis muscle which is located deep in the buttock.
The piriformis muscle connects the sacrum to the upper leg, across the back of the hip joint. The sciatic nerve usually is trapped on the deep side of the piriformis, but in some people the nerve actually pierces the muscle, making nerve compression even more likely to happen. The piriformis muscle is a lateral rotator, and when it tightens it rolls your leg outward. If you sit in a chair, raise one leg straight out in front of you and then roll the entire leg outward so that your toes point to the outside, you can feel the piriformis tighten in your backside. Overuse, such as standing too long, exercising too much, sitting too much, climbing stairs or doing exercises such as squats, can all make the piriformis too tight, so that it pinches or compresses the sciatic nerve.
A simple test is just to try to reproduce the symptoms you experience by doing a piriformis stretch. Lie on your back, bring your knee to your chest and then press it to the opposite shoulder with your hands. If you experience the usual sciatic pain, it's likely that your problem is piriformis syndrome. Your massage therapist can gradually stretch out the piriformis muscles and can balance all your muscles from low back and abdomen to the legs and feet. Stretching exercises can help, as can ice packs or hot packs. If your sciatic pain is due to muscle spasm you should experience relief after a few massage sessions.
If massage doesn't help, you may have a more serious problem such as a herniated disk or spinal arthritis, and you should get an evaluation from your doctor. A final note: something as simple as sitting on your wallet or on a lumpy car seat can compress the sciatic nerve and cause severe pain.
Back Pain and Sciatica
Picture of Sciatic Nerve
Ohio State University Medical Center: Sciatica
Low Back, Piriformis and SI Joint Pain By Erik Dalton, PhD
Assessing Sciatic Pain
- Lisa L. Ross, HHP
- I have actively practiced as a Holistic Health Practitioner (HHP) and massage therapist since 1993 with special interest and training in the Vodder method of Manual Lymph Drainage (MLD) technique. My experience is with lymphedema disease, edema in general, pre- and post-surgery massage, cosmetic surgery edema and more. My search for a low or non impact movement modality led me to become a certified trainer in the GYROTONIC EXPANSION SYSTEM® I have found it to be a helpful movement modality to stimulate the Lymphatic system and other stagnation out of the body. The Gyrotonic method is the base for movement sessions used at the office. Palliative care is another direction of great interest, as many of my clients are in disease states. My mission is to provide compassionate care and resources for my clients.