Pinched sciatic nerve (sciatica) is one of the most common diagnoses in the modern world. It can appear regardless of gender and age. Especially in a big city, which is St. Petersburg, a massage master encounters this problem every day. One of the reasons for its occurrence is a sedentary lifestyle due to office work and a number of other reasons.
Purely anatomically, the sciatic nerve is the largest in the human body. Many small nerve endings depart from it, which are responsible for the functioning of the hip, knee joint, and foot. When the sciatic nerve is pinched, pain passes through the entire hip joint into the leg and can even cause numbness in certain parts of the body. At the same time, it is necessary to massage exactly the area in which the direct pinching occurred.
What is sciatica?
Sciatica is a pain syndrome caused by inflammation of the sciatic nerve and/or pinching of the roots coming from the spinal cord. It is important to know that there are other types of damage to the sciatic nerve, but the localization of sciatica is precisely the lumbar region. Previously, it was simply called lumbosacral radiculitis (lumbago).
The sciatic nerve is the largest in the human nervous system. Its length is from the waist to the knee (then it bifurcates). And most often it is as thick as a thumb.
Symptoms:
- acute pain in the buttocks area (may intensify when sitting, coughing, sneezing);
- standing up is accompanied by shooting pains;
- pain in the buttock, radiating down the leg to the foot, sometimes more severe than in the lower back;
- numbness, burning, tingling, and “goosebumps” are possible in the leg.
It is usually one-sided, but there are also cases of pain in both legs.
Depending on which part of the nerve is involved in the pathological process, sciatica occurs:
- upper (funiculitis);
- medium (plexite);
- lower (trunculitis).
Video: “What is sciatica?”
Symptoms and causes of pain
Typically, painful sensations appear over a fairly wide area. The patient may suddenly experience severe stabbing in the lower back or leg. In this case, the area of the skin in this area may lose sensitivity and become covered with goosebumps.
Among the causes of pain are:
- Intervertebral disc herniation. As a result of too much pressure on the spine, it becomes deformed and the nerve roots are compressed. Many patients with intervertebral hernia, especially of the lumbar spine, begin to have problems with the sciatic nerve.
- Inflammation. Like other nerves in the human body, the sciatic is susceptible to the formation of inflammatory processes. Their catalyst can be injuries, vertebral displacements, acute and chronic diseases.
- Pinching. It is most often observed against the background of injuries, but can also be a consequence of hernia, osteochondrosis and other diseases.
Several factors can lead to painful sensations:
- Sudden lifting of weights. Heavy lifting, which is unusual for the patient’s musculoskeletal system, may well cause the ailments listed above. In addition, a hernia, pinching or inflammation may well develop from prolonged stress on the spine. Therefore, people who work with heavy loads - athletes, loaders, builders - are at risk.
- Osteochondrosis. If a patient has this disease, the spine becomes covered with multiple growths, which begin to put pressure on the nerve roots. The result of such pressure is predictable - the appearance of persistent pain that cannot be eliminated without professional treatment.
- Spondylosis. Another disease that can cause the sciatic nerve to require treatment, and immediate treatment.
- Disruption of the sacrovertebral joint. In such a situation, pain may also appear, since the sacrovertebral joint is located in close proximity to the nerve itself.
The presence of a hernia, pinching or inflammation can be determined by several important symptoms:
- Decreased reflexes – Achilles, knee and plantar;
- Tingling and burning sensations in the leg;
- Weakness in the leg muscles and numbness of the limbs;
- Severe tingling pain.
These are not all the causes of sciatic nerve pain. In any case, before prescribing treatment, the specialist must correctly choose the method of diagnosing the very cause of the discomfort.
Basic treatments for sciatica
Like any conservative treatment, for sciatica it must be comprehensive. There is a standard set of methods, but remember that the doctor must prescribe the regimen individually, taking into account the characteristics of the body, the causes of the onset and course of the disease.
To select the optimal treatment methods, the following diagnostics are carried out: blood tests, x-rays of the spine, CT and/or MRI (computer and magnetic resonance imaging).
Basic methods of treating sciatica, which are used according to doctor’s indications:
- drug relief of inflammation with non-steroidal drugs;
- analgesics - to relieve symptoms;
- physiotherapeutic procedures;
- acupuncture;
- manual therapy;
- various types of massage;
- physiotherapy.
It is important to understand that the popular “treatment” of taking strong painkillers is not effective and even dangerous. While only temporarily relieving symptoms, analgesics do not address the underlying causes and will in no way help the body overcome inflammation and reduce the risk of exacerbations in the future.
For successful treatment, physiotherapy must be present . In the absence of contraindications, it is worth including massage as one of the most effective methods.
The use of massage for sciatica
Let us dwell a little on the reasons why massage as a method provides serious assistance in the fight against inflammation and pain symptoms:
- The main positive effect is normalization of tissue blood circulation and improvement of lymph outflow . This helps, among other things, relieve swelling.
- Removing muscle blocks and relaxing muscles . This allows you to relieve the sciatic nerve and blood vessels from spasms.
- (acupressure) method This helps cope with inflammation and relieve spasms using the body's reserves.
Massage for sciatica can be general or local (only on the affected area).
Depending on the stage of exacerbation or remission, they do:
- Relaxing massage. In the acute stage, this is the only thing you can do.
- Massotherapy. It is used only in the absence of exacerbation and for its prevention. This type of massage is more intense and should be performed by a specialist.
Depending on the part of the nerve lesion (upper or lower sciatica), in addition to the back, the arms or legs are also massaged.
In addition to traditional manual massage for sciatica, these types are very effective and widely used:
- Vacuum (can). It can be targeted (“place the jars”) or dynamic – moving the jar across the skin.
- Acupressure (point). If we are talking about a full-fledged acupressure massage, where you need to know well which point in the body is responsible for what, it should only be performed by a specialist so as not to cause harm. But stimulation of several standard points in the treatment of sciatica (we will discuss them below) can be performed independently.
- Honey massage. A relaxing type of massage, also suitable for home use.
Massage is not used for exacerbation of sciatica. In general, massage is considered a safe method for sciatica and has almost no contraindications.
Obvious contraindications are only purulent tissue lesions or skin diseases in the area of impact and spinal injuries, which require caution and only a qualified approach (depending on the doctor’s testimony).
And, as already mentioned, sciatica in the acute stage is a contraindication for therapeutic massage , which includes intense techniques (squeezing, rubbing, vibration).
The effectiveness of massage also depends on what caused the pain. With one pinched nerve, the method gives the maximum effect, but if there is inflammation, it is used as an auxiliary method.
In this case, drug treatment cannot be ignored. For inflammation, warming ointments are usually used, including massage.
Want to know how to treat sciatica at home? Pay attention to the following articles :
- How is medication treated for sciatica and how effective is it?
- You can read about the use of injections for sciatica at this link
- The treatment of sciatica using traditional methods is described on the next page
Prevention of pinched sciatic nerve
To prevent pinching of the sciatic nerve, you must follow simple rules. Lead a healthy lifestyle with adequate exercise. Light running or swimming are great for strengthening your muscle corset. Excess weight has an extremely negative impact, which puts a strain on the entire body. You also need to take care of the quality of your sleep by purchasing a good orthopedic mattress. And while working at the computer, pay attention to your posture and lean on the back of your chair.
When playing sports, you should take into account all the risks during exercise and avoid exhausting exercises. Adequately evaluate weights when lifting them in the gym. Instead of a beautiful figure and defined muscles, you risk getting health problems. And if you need to lift weights at home, transfer the load to your legs, not your back.
Techniques and features of various types of massage for sciatica
Classic manual massage
A relaxing massage during an exacerbation helps to warm up painful areas, improve lymph and blood circulation, which helps reduce pain. Usually, even after the first session, patients feel relief.
General massage technique:
- The patient lies on his stomach and is as relaxed as possible.
- The painful area is warmed up by stroking.
- The massage uses circular and ridge-like movements, without putting pressure on the affected areas.
- Finish the massage with light strokes.
, the entire back or also the leg (for lower sciatica) is massaged in the same way . During pain, intense exposure should be avoided: vibrations, tapping, strong rubbing. All this will only increase the spasm, and will not make the patient’s life easier.
Any massage for sciatica should be done with caution due to the proximity of the spinal cord to the site of inflammation. Ideally, even a relaxing massage is best left to a professional, but if there are no contraindications or spinal injuries, loved ones can help with it at home.
Therapeutic massage, which is performed during remission and is much more intense, should only be performed by a specialist.
Video: “Massage for sciatica at home”
Vacuum (cupping) massage
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Vacuum treatment is primarily aimed at eliminating lymph circulation disorders in the affected area . Its normalization has a very beneficial effect on the condition of tissues and accelerates recovery. In addition, cupping immediately relieves pain.
The method of placing cups for medicinal purposes, which has long been used by people, is also a kind of vacuum massage. For sciatica, you can “place cupping” to alleviate the patient’s condition and activate lymph flow.
How to place jars correctly:
- The patient lies on his stomach. To prepare the tissues, it is better to slightly warm up the lower back with stroking and a light relaxing massage.
- Place small glass jars, first freeing them from oxygen with a burning “torch” (cotton wool wound around a metal object and soaked in alcohol). It is better that the jars are special for medical purposes. In the absence of them, you can get by with small ones, such as mayonnaise ones (without sharp edges).
- Cover with a light blanket.
- The duration of the procedure is from 10 to 20 minutes. Then the jars no longer hold so tightly, and they are removed.
- After cupping, you can do a light soothing massage with stroking. It is better for the patient to lie under a blanket for at least half an hour.
You should not use large jars, this can lead to injury. It is best to place jars before bed.
Precautionary measures:
- Do not use synthetic materials for ignition: only natural cotton wool and alcohol should be used. This is important to avoid additional tissue intoxication in an already unhealthy area.
- Do not use bottles instead of jars or jars that are too large. This won't help, it will only hurt.
To perform a vacuum massage, in which cups are moved over the skin, some skill may be required. It is good if it is carried out by a specialist, but if desired, the technique can be mastered.
This massage can be done with glass jars, but it is better to purchase a special silicone one, which is much more convenient because it does not require ignition.
The sequence of such a procedure:
- The skin in the affected area is lubricated with massage oil, quite generously.
- The jar is set on fire if it is glass or the air is released by compression if it is silicone. Apply to the area where there is pain.
- Perform movements on the skin with the cup: straight, spiral, s-shaped. The movements are slow and during them the can should not lag behind the skin. If this happens, install it again.
- After the procedure, it is better for the patient to wrap up his lower back and keep warm for some time.
This massage may be a little painful, but it should not hurt too much. Duration 5-15 minutes.
Acupressure (acupressure)
Massage of active points is recognized as a very effective method of treating sciatica, but it is difficult to master and is not suitable as self-treatment . Here you need to understand well what this or that point on the body is responsible for.
The procedure is carried out in several stages:
- First, the point of greatest pain is identified by palpating the area along the sciatic nerve.
- Massage the found point and the entire painful area.
- They massage the buttocks.
- Finally, massage the meridian points of the bladder.
Acupressure of known points for the treatment of sciatica does not harm and can be used as self-help.
Usually 4 points are massaged:
- Find the point of greatest pain in the sacral region. To do this, move the muscle away from the bone using rotational movements. This is the point at which inflammation begins.
- At the bottom of the buttock there is a gluteal fossa, in which the 2nd point is located.
- The next one is under the knee, on the back of the joint.
- The lowest point is at the junction of the foot and shin, in the center.
Pay attention to which points are massaged for sciatica
Massage these points clockwise and back, or simply pressing with your thumb, for 30 seconds to 5 minutes.
Honey massage
Honey massage is difficult to classify as relaxing due to some pain , which patients report. However, the effect is only on the skin, without deeply affecting the muscles. For this reason, it is also acceptable in the acute stage of sciatica, as a good method for activating blood circulation in the tissues.
For such a massage you will need high-quality honey. The technique is not particularly difficult, it can be done at home, but, like any type of massage, it is still better to entrust it to a professional, if possible.
Sequencing:
- Apply a tablespoon of honey to the lower back, which is best warmed slightly.
- Let the honey absorb (2-3 minutes).
- Rub the remaining honey into the skin.
- Make light pats with your palms. During them, your hands will stick to the skin, and this moment causes pain. It is important not to overdo it and listen to the patient’s feelings.
- You need to finish the massage after a white coating appears on the skin.
- Remove plaque with a cloth soaked in warm water and wrap the patient’s lower back.
Diagnosis of pudendal nerve neuropathy
Today, there are clinical criteria that suggest pudendal neuropathy. We are talking about the Nantes criteria. Answer yourself the question whether you have these clinical symptoms.
- Pain in the area of innervation of the pudendal nerve: from the anus to the clitoris/head of the penis.
- The pain is felt worse when sitting.
- The pain does not cause awakenings at night.
- The pain is not accompanied by a decrease in tactile sensitivity.
Additional criteria:
- The pain is burning, shooting, stabbing, and may be accompanied by slight numbness.
- The pain worsens during the day and subsides after sleep.
- Mostly the pain appears on one side.
- Pain may be triggered by defecation.
If you notice that you have these symptoms, you should immediately consult a doctor.
Already at the initial appointment, the doctor will be able to conduct additional special manual tests.
Only a urologist specializing in the treatment of pelvic dysfunction should perform a manual examination (both in a gynecological chair and on a couch). This is due to the need to thoroughly and carefully examine the areas most susceptible to compression. An insufficiently complete examination is fraught with the loss of valuable diagnostic information, incorrect interpretation of symptoms and low effectiveness of treatment.
The next step is to conduct electrophysiological studies,
for example, assessing the bulbocavernosus reflex using electromyography.
All possible diagnostic methods are carried out at the Expert Urogynecology Clinic by highly qualified specialists in the field of pelvic floor pathology. Differential diagnosis is carried out with lesions of other pelvic nerves, as well as with myofascial syndrome. The latter is characterized by painful sensations when pressing on various trigger points in the muscles.
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