(can your massage therapist tell the difference?)

Sciatica is a “garbage can” term, often used to refer to any pain that travels down the leg.  True sciatica is buttock or leg pain caused by injury to or pressure on the sciatic nerve.  The sciatic nerve is comprised of nerves that originate from the lumbar 4-5 and sacral 1-4 levels of the spine (the lower back/tailbone regions).  This large nerve descends into the buttock and runs under (or sometimes through) the piriformis muscle and then passes down the back of the thigh, behind part of the hamstring muscle, and then continues behind the knee and into the calf. 

Three things make nerves mad: pressure, tension, and friction. Because of the interesting “geography” of the sciatic nerve, it can experience any or all of these at many points along its path.  For example, it can sustain pressure by tight muscles along the spine where it begins.  A familiar condition known as “piriformis syndrome” is sciatic nerve pain caused by this muscle compressing the nerve as it passes beneath.  Likewise, the hamstring can friction the nerve since it lies beneath this large, strong muscle.  Sitting in a chair that is too high for your size can create pressure on the sciatic nerve at the back of the thigh resting on the chair seat.  Habitually crossing one’s legs can also make this nerve mad.  Once mad, the very characteristic searing, shooting pain of “true sciatica” begins.

But there is also “false” sciatica, things that mimic sciatica.  The first class of “fakers” is trigger point referrals from muscles.  Unhealthy muscles in the buttock, low-back and thigh can create pain in the same pathway down the leg as sciatica.  The same is true of the second group of “fakers”, certain ligaments near the sacrum that also refer to sciatic-like pain in the leg.  “Faker” number three is the bursas (fluid-filled sacs that act as cushions over bony projections), which also refer to their own pain down the leg.  

Your massage therapist must understand True and False Sciatica. Each false sciatica source and true sciatica require completely different treatment protocols/techniques to remedy this exquisitely painful problem.  Our skilled therapists can decipher the cause of your sciatic symptoms and can address the source with our high-level PNMT approach.


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