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Sciatica? or maybe not......

Lots of people experience sciatic pain and will immediately assume they have the condition "Sciatica". It can be excrutiating, debilitating and unbearable, but what is it?

Nerves exit from the spinal column in the lumbar region of the spine and combine to form the "Sciatic nerve" which then descends through the pelvis to the leg and foot. Irritation of this nerve can cause pain, numbness, pins and needles and a burning sensation or a combination of these along the path of the nerve or in the back. There are several causes of "True" Sciatica.

Prolapsed disc, (sometimes mistakenly called a "slipped disc") where the disc between lumbar vertabrae bulges out of position which then irritates the nerve root at the spine.

Spondylolisthesis, which quite literally and correctly means a vertabrae that has slipped out of place and which irritates the sciatic nerve.

Spinal Stenosis, in which the spinal cord canal narrows and impinges the spinal cord or nerve exiting the canal.

So, the word "Sciatica" is a term used to describe the outcome, not a diagnosis in itself.

The conditions listed above are beyond the scope of a Sports massage therapist and you should always seek the advice of a medical professional. However, there is another condition which can irritate the sciatic nerve and cause similar pain, namely, "Piriformis Syndrome" and this is quite squarely within the scope of a Sports Massage Therapist to deal with.

Pelvis and Piriformis muscle

​The Piriformis muscle attaches to the sacrum at the base of the spine, runs across your bottom to the top of your leg bone (femur) and it is responsible mainly for rotating the leg outwards. Try it.... put your fingertips toughly on the centre of your bottom cheek, press lightly then twist your foot and leg outwards. You should feel the Piriformis tense under your fingers. Be aware that it is a deep muscle and it may take a few tries.

In 10 - 20 % of the population the sciatic nerve can run through the middle of the muscle and in many more it runs directly beneath it, getting squeezed between the Piriformis and other leg rotators. Normally, this doesn't cause a problem but the Piriformis can get tight and dysfunctional just like any other muscle, and that is when it can cause a problem because it interferes with the sciatic nerve, causing pain identical to the other conditions. Hence, it is often confused with "true Sciatica".

The good news is that a good Sports Massage therapist can conduct special tests to assess whether this may be the cause of the pain. If so, they can ease the muscle tension which is likely to ease the pain and they can give you stretches to keep it eased. Often, simply sitting on a tennis ball placed under the bottom can assist. You should still always consult your GP or other health professional as a therapist cannot diagnose or rule out another underlying condition, but they can provide relief from the pain and discomfort.

Be aware that although sciatica is common, there is a rare but serious condition that can be mistaken for sciatica. If you experience the following symptoms please seek urgent medical care:

  • Numbness around your genitals and buttocks

  • Loss of bladder and/or bowel control

  • Sciatica in both of your legs

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