Sciatica is nerve pain related to the Sciatic Nerve. This nerve stems from the low back, or lumbar spine, and runs through the butt, thighs, legs, and feet. It relays messages and innervates muscles down through the lower extremities. There are two situations whereby the nerve can get pinched or compressed, and these cause nerve related pain. These two conditions have different causes and effects. However, they both can cause symptoms, which can be characterized as burning, numbing, tingling, stinging, or shooting pain.

The first condition is called True Sciatica. This is when the root of the Sciatic Nerve is compromised; the root sterns out of the lumbar spine. There are a number of problems that may occur to the lumbar discs, and most of them created by compressive forces from the weight of the body being supported in poor postures.

Running, as another example, puts compressive forces on our bodies that are 3-4 times our body weight. The most common type of lumbar disc pathology is disc degeneration, which can lead to herniation and rupture.

Constant or chronic pressure over time will cause the fibers of the disc to break down. As the fibers break down, the inner fiber called nucleus pulposis will press against the side of the disc.

This will cause the disk to protrude and lose its circular shape. The nucleus material is somewhat spongy so it is not immediately absorbed by the body. It may press on the sciatic nerve root causing radiating pain down the length of the nerve. This can be an important difference. True Sciatica, with pinching at the root of the nerve, will refer pain to the most distant site into the toes.

The other sciatic related pain is called Piriformis Syndrome, which generally only refers pain locally or to the knee. As the Sciatic Nerve runs into the butt, or the gluteals, it can be pinched from overly tight gluteal muscles. More specifically, in some people, it can actually run directly through the fibers of the Piriformis muscle. The Piriformis muscle is one of the six deep lateral rotators. It’s the largest and strongest of these six muscles.

Depending on severity, pain may be felt in the immediate gluteal region, down the back of the thigh, or all the way down the leg, if the compression on the nerve is sever. This can mimic the symptoms of True Sciatica. The Piriformis Test and the Straight Leg Test can better identify the source of pain. Some common activities that use these muscles would be rollerblading, skate skiing, breastroke, and dance. Imagine a ballet dancer and the position of the feet; they are often laterally rotated to an extreme position. Do you think Charlie Chaplin may have had tight lateral rotators?

So, how can you get help for these two sciatic related pains? As far as disc related pain is concerned, there are specific diagnostic tests such as a Myelogram, X-Ray, or MRI which may be needed; Check with your Doctor. In some instances information gained form physical examination may be helpful in determining the nature of the condition. With disc protrusions that are causing pain down the leg, there are several characteristics to watch for.

Pain from disc problems tends to be worse when sitting for long periods. Disc compression is greatest when in the sitting position. Movements in one direction may aggravate the pain and a slight change in the movement may relieve that pain. This will happen as the pressure is relieved on the nerve by slightly changing the position of each vertebral segment. With disc pathology, pain seems to decrease with activity. With pain of a muscular origin, pain will usually increase with activity. Some clarification may be gained by performing the straight leg test with a knowledgeable practitioner.

If the pain is muscular in origin, massage and stretching can be effective. Careful application of these skills to ensure that the nerve, which is already irritated, is not being irritated further.

Massage Therapy can indirectly be effective for disc related sciatic pain. Many muscles attaching to the transverse and spinous processes of the lumbar spine become tight in reaction to the pain. This tightness increases the compression on the disk and may aggravate the condition. Releasing tightness on these muscles in an indirect way to interrupt the cycle or pain and muscle tightness causing the compression.