What is sciatica?

Sciatica is a common pain condition that is easy to explain but hard to treat! The symptoms present as pain, numbness, and weakness down (usually a single) leg. The pain can be sharp or simply irritating, and can radiate all the way down to the feet. There may also be leg numbness or weakness, particularly after having been sitting or lying down for extended periods. It is caused when the sciatic nerve (which runs from the lower back, through hips and buttocks, and down each leg) becomes trapped, irritated, or compressed. Some degree of sciatica is extremely common, with an estimated 40% of people (in the United States) experiencing it during their lifetimes.

The root cause is hard to reliably identify because there are numerous possible underlying causes of the nerve irritation. The most common is a slipped disc, where one of the cushions between vertebrae pushes out to one side. But other causes may be “spital stenosis” in which a part of the spine that nerves (including the sciatic nerve) pass through is narrowed; or a condition called piriformis syndrome (spasming of the piriformis muscle in the buttocks).

How can it be treated?

Sciatica normally resolves within a few weeks or months, but given the irritation many people seek treatment in the meantime. Remember what we are talking about here is treatment of the symptoms, rather than treatment of the underlying nerve irritation. Treatment for the latter is rarer and harder, and may involve surgery to “decompress” the nerve.

As for treating symptoms, most GPs will recommend self-care at first: gentle exercise, some special mobility and stretching exercises, heat packs, as well as lifestyle changes (posture correction, better technique for lifting heavy objects, regular exercise). If the symptoms persist then a referral for physiotherapy will often result in a recommendation for massage. This could be self-massage using a special ball or roller, or professional massage treatment.

The common types of massage recommended are sports massage, Swedish massage (whose longer strokes can be beneficial), and deep tissue massage (which we can provide). Any type of massage can help with temporary relief from the sciatica pain. Deep tissue work can be particularly effective if tightness in the piriformis is causing the nerve irritation.

If you do visit Thai Kosai for help with sciatica, please remember that we are not physiotherapists! We cannot help develop a rehabilitation plan, or give a medical diagnosis of the underlying cause of the nerve compression. But we are happy to provide deep tissue massage, to explore whether loosening the muscles in the lower back, glutes and legs helps, on either a temporary or a more lasting basis.