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Derek Golightly - Massage Therapist

Remedial & Sports Massage


Sciatica

Sciatica has to be approached with great care. The underlying cause is usually postural. This page describes sciatica in general terms, and the approach I use to solve the problem. I cannot guarantee to fix all conditions of sciatica, but I've seen it written that up to 80% of sciatica sufferers can be helped by the approach that I use. Certainly my experience bears this aout.

There are a number of postural problems that can cause sciatica. One example is:
  • If your pelvis is tilted forwards it will cause the curve in your lower back to be exaggerated, and this in turn can cause the gaps in your spine where the nerves exit the spinal column to be reduced. Thus the nerves can be impinged as they exit the spinal column. Very often this results in sharp pain into the lower back and/or the legs.
The solution is to correct the tilt in your pelvis. The underlying cause of the tilt is virtually always a muscle imbalance. So, fix the muscle imbalance, and the pelvis tilts back to where it should be, and the pain goes away. The trick is to recognise the exact nature of the postural problem, and to know how to fix the associated muscle imbalance.

Incidentally, there is another cause of impingement on the sciatic nerve. This is known as piriformis syndome. In this case, the solution is still to correct the pelvic tilt, but the approach to the muscles might be different. This is because, in one form of prirfomis syndrome, easing the piriformis will bring immediate relief.

A common mistake is to just dive in to massage the muscles that appear to be the source of the pain. Unfortunately, these muscles are often tight and tender because they are overworking. They are overworking because they are preventing your posture from getting worse. So, for example, easing the gluteus maximus may give immediate relief while lying on the massage table, but it will result in your pelvis tilting forwards and making the impingement on the nerves worse. Hence my earlier statement that sciatica has to be approached with great care.

So, the first thing I do when treating someone with sciatica is do a postural assessment. I will then ease the muscles that it is wise to ease, and suggest exercises for the client aimed at correcting the postural problem.

Doing the exercises is the thing that will ultimately fix the sciatica. However, as a massage therapist, there are things I can do to speed up the process. These involve using various stretching techniques on targeted muscles and also "releasing" specific muscles.

Furthermore, I've found that sciatica is also often accompanied by pain in muscles that are not directly involved in the sciatica. This is due to the knock-on effects of the postural problem. I can help to remove the immediate cause of this pain.

I should also mention that unfortunately sometimes the problems in the spine are too severe for this kind of approach to work. This is the minority of cases. The only solution that I know of is surgery. Anyone who is developing sciatica would be wise to fix it before it gets to this stage. It is a fact that sometimes sciatica goes away of its won accord, but sometimes the postural problem just continues to get worse. In either case, do something about it now. You really don't want to get into this kind of severe situation.




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