RELIEF FOR SCIATIC PAIN

 Sciatic pain can be a debilitating disorder that is characterized by pain deep in the gluteal region that can travel into the low back as well as down the posterior of the lower extremity through the hamstring  and calf muscles. Sciatica is is a form of neuritis, or nerve inflammation that is often is a secondary condition caused by intervertebral disc lesions found at the levels of L4-L5 and L5-S1 in the low back region, spondylosis, hip dislocations, lumbar disc subluxation, intra-uterine pressure during pregnancy, trauma to the branches of the sciatic nerve, sacroiliac disease, and soft tissue compression from the piriformis muscle and fascial restrictions. 

Piriformis Muscle

The piriformis muscle plays a role in hip abduction and lateral rotation of the hip. The significance of this muscle is its proximity to the sciatic nerve as it exits the sciatic notch. In most cases, the sciatic nerve passes beneath the piriformis muscle as it travels down the posterior leg. For some, the sciatic nerve passes through the piriformis muscle, making it susceptible to compression of the piriformis muscle from trauma or spasm. 

Reasons for Piriformis compression

• Prolonged sitting
• Overuse
• Recent increase in activity
• Trauma to the gluteal region

" For some, the sciatic nerve passes through the piriformis muscle, making it susceptible to compression of the piriformis muscle from trauma or spasm."

Facial Compression

Fascial is a form of connective tissue (CT) that is layered throughout the body. The deep fascia is irregular CT, where the fibers are organized in a haphazard pattern that separate muscle into functional groups. This construction encourages freedom of muscle movement, support for nerves and blood vessels, and space between muscles. As the sciatic nerve makes its way from the spine to the foot, it must weave through muscles and fascia. Restrictions in these fascial sheaths can result in compression of the sciatic nerve and its branches.

Other causal factors

• Leg length discrepancy
• Foot disorders, e.g., pes planus (flatfeet) and pes cavus (high arch)
• Lordosis (Excessive low back curve)

Massage can be an effective means of treating both the muscular and fascial components, hence the term myofascial. It is necessary to release any tension along the path the sciatic nerve travels including the gluteal muscles, hamstrings, and calf muscles, the gastrocnemius and soleus. Treating the low-back region may be needed as well. A thorough investigation of these areas is crucial for better outcomes for pain-relief and improved function of the low-back and hip. Self-care can include daily stretching and self-massage with a foam roller. I caution a conservative approach when using foam rollers. Too much force applied can aggravate the condition.