The Sciatic Nerve
The sciatic nerve is the largest nerve in the human body and it arises from L4 to S4, which is the sacral plexus. The sciatic nerve supplies responses to the buttocks, perineum and lower limbs. Symptoms of sciatica include pain and inflammation that may extend from the lumbar or gluteal region, all the way down to the legs and feet.
Sciatica pain is one of the most common, yet most misunderstood complaints heard in massage therapy. Often, people who suffer from lumbar or gluteal pain will come in saying they have sciatica; but what is a true sciatica? Were they properly diagnosed or are they self-diagnosing?
There are 2 types of sciatica:
1. True or primary sciatica: when a true compression and inflammation of the sciatic nerve root is caused by a spinal dysfunction like a herniated disk or spinal canal stenosis.
2. Neuralgia or Piriformis syndrome: when the piriformis muscle or surrounding regions are causing the compression of the sciatic nerve simply due to muscle tension or misalignments of the joints.
The causes of either case can be due to poor posture at work and at rest, repetitive strain, a wrong movement, or heavy lifting.
Is massage therapy good for sciatica pain?
Massage therapy is effective and beneficial for those suffering from sciatica. The massage therapist will collect information, an anamnesis, which will help determine the cause and type of condition it truly is. This should include a confirmation through observation, in other words- a postural analysis. Anterior, lateral and posterior views can help conclude anomalies and differences in the bony contours and soft tissue. This can lead the intervention, the massage, to release tissues in need of relaxation. The massage therapist should focus on rebalancing structures through separations of the muscles involved to help reduce compression along the nerve path.
Does sciatica go away on its own?
Lots of people ask this question and unfortunately the answer is no. The body is smart enough to compensate in order to reduce discomfort, however this means the initial problem is not solved and only masked for a period until other symptoms start to arise. Compensations include standing on the unaffected leg, a thoracic rotation, or a modified seated position so that you don’t feel the pain.
Sciatica must be worked on physically and actionable daily habits must be performed in order to prevent it from coming back. Prevention includes specific muscle relaxation and stretching then strengthening, self-massage and maintaining a good posture.
Sciatica pain relief from home
Water/Diet: Drinking water helps to keep your tissues healthy by removing waste and carrying nutrients to the affected area. Water helps to keep your spinal discs hydrated and reduces inflammation. As for which foods to eat, diets rich in magnesium have been shown to promote sciatic nerve regeneration. Magnesium is what helps muscle tissues to relax and regulates muscle contractions. Leafy greens are chock full of magnesium and it is also advised to eat foods rich in omega-3 fatty acids, vitamin B, and antioxidant-rich foods, all of which help reduce the inflammation associated with this condition.
Stretch: As mentioned above, muscle relaxation and stretching comes first. Favoring stretches which flex the hips reduces discomfort and promotes relaxation.
Hip external rotation/flexion: Find a surface that is hip level, start with one leg on the surface with your knee bent, it should look like a Figure 4. Then slowly bend the standing knee and lower to a point where you first feel a stretch in your glutes. Hold the stretch for 30-60 seconds then switch to the other leg. Perform this for a set of 3x.
Hip flexion: Aka child’s pose. Start in a table-top position then slowly lower your glutes to your heels. Lower your upper body to rest on your forearms. Your glutes may not be touching your heels and that is perfectly fine, you can get there through a sequence of breaths. With each exhale, empty the air out of your abdominals and fold a little more. Stop when you feel a barrier and hold for 30-60 seconds; perform for a set of 3x.
Strengthen: Once the area has been stretched and warmed-up it is ready for some active contractions. Only perform these if you’re no longer feeling any pain after stretching. If you still have pain continue with the stretches or foam rolling until exercise can resume.
Unilateral hip flexions: Laying on your back, inhale, then on the exhale, simply raise one leg with a bent knee to a 90-degree angle and slowly lower back down with a straight leg. This creates a light movement in the hip joint and tests range of motion. Perform on each leg for 12x then switch leg. Perform on the affected leg more times as needed.
Hip extensions/bridges: Laying on your back, both knees are bent, and the feet are flat on the ground. You should be able to touch the back of your heels with your fingertips. Inhale, then on the exhale, squeeze your glutes and raise your hips, slowly lowering back down. Do this 12x for 3 sets.
Foam roll/Massage ball: Foam rolling or massage with a ball is another effective way to help sciatica pain at home. Foam rolling in general can be used to soothe and relieve tight muscles.
Go-to move #1: Figure 4 glute roll-out, 2 minutes per side.
Go-to move #2: IT-Band roll-out, 60 seconds per side
Go-to move #3: Hamstring roll-out, 60 seconds per side.
At-Home essentials
Finally, here are my picks for your at-home essentials needed to relieve sciatica pain. Luckily, it is also Prime Day on Amazon.com or Amazon.ca, so you can invest in yourself for less! (As an affiliate I do make commission on any of these purchases, so I thank you for your support).
My choice foam-roller, massage ball, yoga mat and magnesium. All of these products are the ones I use every day. I find them effective and supportive for my every day needs and I'm sure you will too!
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