What is it?
Sciatica is one of the three main clinical manifestations of lower back pain. The other two are pain caused by spinal stenosis and nonspecific back pain symptoms that are often related to problems with various back muscles.
The term “sciatica” is used to describe a number of disorders directly or indirectly affecting the sciatic nerve. Patients with sciatica often feel pain along the anatomic path of the sciatic nerve and its branches: along the lumbar spine through the gluteal area, down along the back of the leg and calf to the sole of the foot or the big toe. Sciatica pain can have a constant or intermittent character. The sharpness of the pain sensation varies and may increase and decrease over a short period of time. The character of the pain can be described as an unpleasant electric shock, heat, tingling, or a stabbing or almost unbearable pain sensation.
Because of its significant size and length (it is the biggest nerve in our body), the sciatic nerve is subject to many types of injuries and inflammations. For example, sciatic pain can be caused by a herniated disk, arthritis of the spine, and pressure on the nerve from certain types of exertion. The sciatic nerve also can be damaged by toxic substances such as lead or alcohol. Occasionally diseases such as diabetes mellitus, gout, or vitamin deficiency contribute to sciatica pain.
In the majority of sciatica cases, where pain and inflammation are caused by soft tissue injury, a proper combination of HAs and SAs produces the optimum pain relief by reducing the inflammation of nerves and muscle. Nerve inflammation is liable to cause pain in the muscles it innervates. Treatment relaxes the painful muscles and increases blood circulation, the general effect of the treatment is to reduce the inflammation of nerves, muscles, and other soft tissues, resulting in relief from the pain of sciatica.
Deep tissue massage and acupressure massage coupled with trigger point release and muscle energy technique should start to relieve the pain, relax restricted muscles and release any nerve impingement right from the first treatment session. From then on treatment will be tailored to follow the reaction to the previous treatment ensuring that the injury and restriction are released with the minimum number of sessions.
The sciatic nerve sits underneath a muscle called the piriformis, which is located beneath the glutes. When the piriformis muscle gets tight, it pinches the sciatic nerve, causing tingling and numbness down into the leg, pressure is applied to the irritated and inflamed areas, or trigger points, in the piriformis muscle, as well as in muscles in the lower back and glutes.
Acupuncture in the lower back, hip and gluteral area can be part of the treatment with further distal needles inserted further down the legs. Relief can be as speedy as the first session with further sessions helping to build the recovery incrementally.
Because the sciatic nerve is buried deep within the buttock and leg, ice or heat on the surface of the body won’t ease the inner inflammation. But the time honoured treatments can act as counterirritants, that is, they give your body other inputs in the painful area, and that can bring the pain down quite significantly, apply an ice pack or a heating pad as needed for 10 minutes.
Treatment sessions are planned at 5 to 7 days apart initially but spaced further apart as treatment start to take effect.
Moving is usually the last thing people dogged by sciatica want to do, but it’s important to be physically active. Lying in bed makes it more likely that the pain will last longer, exercise increases blood flow to the restricted area and the nerve, helping to get rid of the chemicals causing the inflammation. Take 15- to 20-minute walks, if that hurts too much, give swimming or water aerobics a try, there’s not as much pressure on the back when you’re in the water.
Stretching exercises to restore flexibility to the back or moves that strengthen core muscles, helping to stabilize the spine and reduce the likelihood of a similar injury will also be part of the aftercare and maintenance sessions.
- Postural and functional assessment
- Deep tissue massage
- Tui Na (Chinese massage and manipulation)
- Acupressure massage
- MET (muscle energy technique)
- RI (reciprocal inhibition)
- Trigger point release
- Muscle re-education, to improve muscle control
- Electrotherapy (TENS)
- Exercise programs, to strengthen your muscles and improve movement
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My areas of expertise
- Sports Therapy
- Tui Na, ( Chinese Massage and Manipulation)
- Traditional Acupuncture
- Specialised Body Acupuncture
- Auricular Acupuncture
- Traditional Chinese Medicine (TCM)
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