Sciatic Pain – True or False?

Sciatic pain is a common occurrence with similar symptoms that can result from two very different mechanisms.  There is a significant difference between medically defined ‘sciatica’ and ‘false sciatica’.   Sciatica involves nerve entrapment – a focal nerve lesion produced by constriction or mechanical distortion of the nerve, within a fibrous or fibro-osseous (boney) tunnel. A serious condition which left untreated can lead to loss of enervation to an area as well as nerve death. The ‘trapped’ nerve may be further damaged by stretching or bending. In the case of ‘Sciatica’ the sciatic nerve may be entrapped between spinal vertebrae as it exits the spinal column. Often treated through surgical methods of bone, cartilage or tendon removal.  Before resorting to surgery, I would recommend consultation with a chiropractor to determine if a spinal mis-alignment is the cause of the entrapment. Massage may temporarily relieve spasmed muscles and resultant pain in the area, but can not provide any permanent relief unless  mis-aligned vertebrae move back into position as a result of muscle relaxation.

‘False sciatica’ or Piriformis Syndrome is the result of nerve impingement – pressure against a nerve by the skin, fascia, muscles, ligaments, or joints.  The impingement of the sciatic nerve in the hip as it enters the sciatic notch by the Piriformis muscle can result in low back, hip, leg or foot pain, numbness or tingling.  There is nothing ‘false’ about the pain.  This condition often affects runners & cyclists.  Paradoxically, it can be brought on by long term sitting at a computer or in car without getting up and moving around. It can also start out as a mild discomfort and progress to an almost debilitating condition.  Luckily, it responds well to deep tissue massage techniques.

In my massage practice, I  am frequently able to relieve the pain and discomfort of ‘false sciatica’, but if the client receives little or no relief from deep tissue therapy, it is important that they seek additional help from other health care providers such as their chiropractor or doctor.

Don Gillmore, Licensed Massage Therapist(15 yrs), B.S.- Life Sciences

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