Sciatica is a pain syndrome originating most often from the lower spine, caused by pressure on the sciatic nerve or the spinal nerves forming it. Sciatica can be either acute or chronic, significantly affecting daily functioning. Common causes include sedentary work or jobs involving heavy lifting.
What is Sciatica?
Also known as ischialgia, sciatica is a pain syndrome that typically starts in the lower spine, with pain radiating from the buttock through the back of the thigh and leg to the foot. It is caused by pressure on the sciatic nerve (the largest peripheral nerve in the body) or the spinal nerves that form it, located at the lumbosacral junction.
Causes of Sciatica
The primary cause of sciatica is often disc disease, typically a herniated disc, affecting the spinal nerves mentioned above. Other causes may include:
- Narrowing of the spinal canal (often due to degenerative spine changes)
- Piriformis syndrome in the buttock area
- Injury (resulting in nerve damage or trauma, or injection near the nerve’s path)
- Spondylolisthesis
- Local inflammation
- Cancerous changes within the spinal canal
- Systemic diseases affecting nerves (e.g., diabetes)
- Infections
In short, any condition causing irritation along the nerve path may lead to sciatica. Risk factors include:
- Job (sedentary or heavy lifting work)
- Sedentary lifestyle
- Poor diet and excess weight
- Pregnancy
Does Massage Help with Sciatica?
Sciatica can cause tingling, numbness, and pain radiating to the buttock, thigh, calf, and foot. This pain originates in the sciatic nerve, created by intertwining spinal nerves.
The most common cause of sciatic nerve inflammation is compression in the lumbar spine. This compression causes swelling and inflammation, with pain in the buttock and leg originating from the lumbar spine. Similar to a warning light in a car, the pain signals that there is an issue with the spine, and addressing this inflammation is the first step.
When muscles tighten during sciatica, this leads to pain and stiffness in joints, causing muscle knots known as trigger points. Massage relaxes these muscles, reducing pain and preventing contractures and trigger points from forming. In cases of acute sciatica, inflammation in the spine should be reduced first; only then can massage have lasting effects.
Sciatica During Pregnancy – Massage
Sciatica is common during pregnancy. Due to the baby’s wellbeing, many effective treatments and strong painkillers are avoided. The treatment involves lumbar spine rehabilitation and appropriate massage, conducted by an experienced therapist who knows how to safely work on the sciatic nerve and muscles.
Symptoms of Sciatica
Sciatica symptoms can appear gradually or suddenly, often with lower back pain radiating to the lower limbs. Pain worsens with bending over or lifting the leg while lying down (Lasègue’s sign). Other symptoms may include numbness, sensation disturbances, and reduced muscle strength, with excessive muscle tension limiting movement in the lumbar spine.
Diagnosing Sciatica
Diagnosis starts with a detailed interview and examination. One method involves the Hoover’s test—where the specialist places a hand under the healthy leg’s heel and asks the patient to lift the affected leg (if sciatica is present, they may struggle to do so). The Lasègue’s test is more common, causing pain in the affected limb when lifting the healthy leg.
Imaging tests play a key role in diagnosing sciatica, with X-rays revealing degenerative changes. If needed, MRI or CT scans provide additional data, typically when conservative treatments are ineffective.
Treating Sciatica
Sciatica treatment is usually handled by a neurologist and/or orthopedist in collaboration with a physiotherapist or massage therapist. Treatment depends on the severity and includes:
- Physical therapy – includes exercises for glutes, abdomen, legs, and back
- Compresses – cold for pain relief, heat for muscle relaxation
- Manual therapy and massage – targeting specific areas
- Physiotherapy – such as infrared light, ultrasound, and electric currents
If conservative treatments fail, surgical intervention may be necessary. The surgical approach is determined based on the specific cause of sciatica.