What is sciatica?
Sciatica is tingling or pain that runs through the buttock, back of the leg and into the feet. You may have pain or tingling in all or just one place. Often it is made worse by coughing or sneezing, and bending forward to touch your toes or picking something off the floor can make things worse too.
Sometimes sciatica can also cause a burning sensation, numbness or weakness in the legs or feet. It’s not always the case, but often there is either some current or a history of back pain.
It is very often just one leg only but can occur in both. It’s important to get yourself checked out by a GP if you’re suffering leg pain, numbness or weakness because there are a number of causes.
What causes sciatica?
Sciatica is caused by irritation (aka compression) of the sciatic nerve.
This nerve exits the spine near the bottom of the back, runs through your buttock, right the way down the back of the legs to your feet. Which is why you get that pattern of pain or symptoms when you have sciatica.
There are a number of reasons why the nerve might get compressed:
- Muscle tension/spasm – like piriformis syndrome which is more common in the right leg
- Disc injury – either a bulge or protrusion can compress the nerve root
- Spinal stenosis – a narrowing of the opening where the nerve exits the spine
- Spondylolisthesis – when one of the bones in your spine slips out of position
- Pregnancy – the shift in posture and increased weight
Will sciatica get better on it’s own?
In most cases yes. It’s a self limiting condition which means a lot of people will get better in 4-6 weeks (see the NHS website here). It depends on the cause of your symptoms and other factors.
If you haven’t noticed an improvement in your symptoms but a doctor has cleared you, that’s exactly the time to book a Sports Massage appt to start making some progress.
What other factors are going to affect my recovery?
We now know that look at the mechanics of an injury is only half the story. Sometimes pain can be a lot worse or less depending on many other factors. This is to do with the nervous system – making decisions on how importantly or loudly to talk to you about what’s going on. This is pain science (and we are pain science geeks here at HeadStart!)
Other factors that can affect your recovery are:
- Quality of sleep – once you’re in pain this is THE biggest predictor of your improvement
- Depression – often people with depression experience more pain. This does not mean we have to cure you of depression to improve your pain! But it does mean we need to consider this if you are getting slower recovery. And we’ve worked with plenty of people with this before.
- Stress & Anxiety – This is general stress & anxiety, good or bad, it could be the daily commute, worrying about money, looking for a new job or even organising your wedding. All of these factors can affect your experience of the pain and your recovery.
- Survival value – How important is it for you to be pain free? This can go both ways, it can either make things worse because you’re desperate to get better and that’s making you more stress and anxious. OR it could be that because you ‘have’ to make it through that 4hr car journey to see your family it drops the pain to allow you to do that.
- Catastrophizing – This is an important one that we work on in clinic. It’s very important to help challenge the thoughts that you’re never going to be able to…run again, sit without pain, that your disc has exploded inside your body. Why? Because this makes you stressed, and stress increases pain. I think it’s pretty reasonable if you have a numb foot you’d be fairly worried. So this is where we have to find out the cause of your symptoms and work towards a treatment plan that works for you.
- Fear Avoidance – Lying in bed avoiding moving, or worrying that you’re going to damage yourself more if you return to the gym is the last thing we want you to be doing. Think of it like a phobia, to help you improve you sciatica we need to get you challenging yourself a bit – to discover that things ARE ok and you can do things. Of course we modify any movements that are causing pain – but it’s very important you don’t avoid doing things because you’re afraid.
- Beliefs – beliefs like, I’m getting old, or my dad had a bad backs so it’s genetic, or my disc has exploded so I have to be extremely careful about what I do, ALL make your pain worse or slow your recovery. And that’s what we need to address.
Can Sports Massage give pain relief from sciatica?
Because we’re able to help with the mechanical cause of your pain, like muscle tension or spasm. We can find ways to stretch muscles without causing nerve irritation AND we help mobilise your hips and lower back in ways to relieve tension.
Also we’ll address all the factors above.
The discussion with your therapist when you have something like sciatica is just as important as the hands on treatment.
By combining hands on work, calming the nervous system, it makes things more tolerable allowing you to move more normally.
This creates a window of opportunity for you after the appt for you to get moving more and a chance for your brain & body to learn that the risk is lower, hopefully causing a longer lasting effect of reduced muscle tension and improved movement.
Getting deep tissue massage on your lower back, hamstrings, quads, calves and feet is very effective at reducing pain and improving flexibility. Reducing the nerve compression is the most important thing when you have sciatica and Sports Massage is a great way to help.
If you have a condition like spinal stenosis, then of course Sports Massage doesn’t directly affect the bone! But what Sports Massage can do is to keep the surrounding muscles as healthy and flexible as possible. We can maintain the health of the spinal joints as well as improving mobility in the hips. Managing sciatica is just as as important for some people who have a long history of back pain.
We’ll also recommend safe exercises and stretches for you to perform at home. Depending on your specific symptoms you may find a 10min Hip Mobility routine like this effective.
What can I do to improve my sciatica?
- If you haven’t already then make yourself an appt with a GP. It’s important to get the right pain medication. Sciatic pain is nerve pain so paracetamol doesn’t always hit the spot – there are specific drugs to target nerve-based pain which can be effective in under a week.
- Book a Sports Massage with one of our team! We’ll be able to help assess, identify what the causes of the sciatica are and create a treatment to get you back in action ASAP!
- Continue to keep moving. There is a big difference between pain and discomfort here. It is VERY important that you move as much as possible and continue to live life as normally as possible as long as your pain levels are below 4/10. Which to me means it’s going to be uncomfortable but not painful
- Get advice on activities that make symptoms worse. Anything that you notice causes an increase in pain, get some advice. We need to determine if that’s purely because you’ve done too much and the body is fatigued OR if you are increasing the nerve irritation. If you’re keen for a clear template then use our traffic light system for training when you’re in pain.
- Where possible avoid stretches that cause the tingling/pain sensation – it’s unlikely to be causing damage, but you are irritating the nerve and potentially slowing your progress.
- Experiment with different stretches and mobility techniques – often using a mobility ball or foam roller can be really helpful here. Here’s some of our tutorials on how to use a mobility ball or foam roller.
- Relax – this can be as simple as lying down in a comfortable position a few times a day, taking deep breaths or going for a short walk. We really like to recommend body based relaxation exercises like PMR or the free HeadSpace app
Sciatica is a nerve pain caused by compression of the nerve, either at the nerve root in the spine or further down. It can be extremely painful and distressing, and although most cases improve in 4-6 weeks it also can be very stubborn. It is a common condition that we see in clinic and can get very significant improvements and pain relief using Sports Massage to help sciatica.
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