• Chelsa Connolly

The Psychotic Sciatic? The nerve pain that will drive you nuts

Sciatic nerve pain falls into the category of most common complaints we treat clients for. Understanding what's going on, can help you with self-care strategies and management for this common condition.


If you've ever dealt with pain, tingling, numbness or even weakness that runs straight down the back of your leg, then chances are you're already well acquainted with sciatic nerve pain. We once had a client who referred to it as his "psychotic" nerve because it was driving him crazy! There can be multiple factors involved with sciatic nerve pain, and not all pain in the back of the legs is truly sciatica. There also is very good prognosis for most cases with conservative management treatments.


If your sciatica or sciatic like symptoms are driving you insane keep reading to understand more and find some ideas on how you can find relief.


A few quick tips


This blog post is not written to diagnose sciatic nerve impingement, sciatica, sciatic nerve syndrome, obturator nerve impingements or trigger points, only your qualified medical professionals can do that. This post is written to help you understand the structures involved, the theories of how conservative treatments work and what some basic self-care strategies are to manage and prevent sciatic nerve issues.


What is the Sciatic Nerve?

How does massage therapy help?

What can you do for yourself?


 

What is the Sciatic Nerve? Furthermore, what is impingement?

At the bottom of the spine are the biggest vertbrate called the lumbar and an odd triangular shaped bone called the sacrum. Nerve roots exit the spinal canal through the spaces between these bones and eventually join together to make a large cord called the sciatic nerve. This large nerve, roughly the size of a finger serves to provide a pathway for nerve impulses to the hips, legs and feet. These nerve impulses carry the information of sensations to the brain, and the commands that tell muscles to move to the tissue.


Sciatic nerve impingement, or sciatica can occur anywhere along the path of this large nerve. Nerves aren't really a fan of being restricted by other structures, and they generally like to let you know about it. In the simplest terms, this is what an impingement is.


Most commonly we see these impingements in tissues somewhere around the pelvis such as the powerful muscles of hip rotation found on the back side of the pelvis. In this case, those muscles have become the literal pain in the butt. In addition to the soft tissue, at times impingement occurs as a result of the spine itself compressing a disc.


These impingements can happen for a variety of reasons. While some impingement are a direct result of an injury others are often related to activities and movement patterns the individual suffering from sciatic nerve pain has developed.



How can Medical Massage Therapy help?


Soft tissue adapts over time to what movement patterns we each develop. Massage, especially when paired with corrective movement based therapy can help soft tissue to adapt healthy movement patterns to correct dysfunction.


Sciatic nerve impingement that is not related to disc dysfunctions is frequently related to restrictions in the muscles related to the true hip joint on the side of the pelvis. In our western culture where chairs are largely the same, average adults spend their lives either standing or sitting in a handful of positions. The body adapts to these positions by restricting the movement of muscles to stabilize the joints. This leads to a loss in the range of motion at the joint, and tight restricted muscles.


Often times, the sciatic nerve pain is due to the tight and restricted nature of those muscles not allowing for freedom of movement of the sciatic nerve along its path. However, there is one other suggestion that can mimic sciatic nerve pain but has no nerve involvement. Trigger points are areas within muscles that are sensitive to the touch and elicit a response elsewhere in the body. Frequently, trigger points will develop and cause discomfort in defined common patterns.


Several of the muscles within the glutes develop trigger points that refer pain across the hip, or down the leg, mimicking sciatic nerve pain.


Medical Massage, or any orthopedic focused massage will address restrictions in the tissues we know to commonly cause impingement over the sciatic nerve, as well as working with trigger points.


It is important to note, that while massage therapy frequently helps to reduce or even resolve the symptoms of sciatic nerve pain, they cannot diagnose any of these conditions. Referrals from doctors help to make their job easier.


What can you do for yourself?


Massage can help to reduce the symptoms of sciatic nerve pain of many cases. In addition to massage therapy a home stretching a movement routine will help as well.


An effective home stretching routine is focused on hip mobility, core strength and lumbar stability. While these may sound intimidating, a few efficient exercises can be done seated in an office chair. Crossing your legs into a figure four stretches the hip rotators and capsule. Pelvic tilt exercises that engage from the pelvic floor upward work to stabilize the core and lumbar together into a more efficient chain of movement.


Additionally, walking can not be overstated as it opens the hips and requires movement to be initiated into daily routines. Any movement is improvement over no movement and you may be surprised how many issues will resolve with motion!

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