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.