Sciatica is any of a number of conditions which causes irritation and sensitivity in and around the sciatic nerve. This nerve bundle originates in the lower lumbar intervertebral foramen (fancy term means holes between your vertebrae); and it is here that the problems can start.
If intervertebral discs are involved, the pressure comes from an unusual direction. Compression of the disc on the opposite side causes the disc to lose its shape and herniate (bulge) in the direction of the nerves leaving the spinal column, causing compression of the nerve roots bringing pain and/or loss of sensation.
If the problem is here, good posture is your best friend. Keeping the spine neutral reduces the compression, and the tension of the muscles in and around the low back. Massage can help balance the muscles of your spine to restore your posture, and even out the pressure between the two sides, thus speeding up the healing process over posture alone.
For self care, Yoga could be extremely beneficial; find an instructor who understands your condition and can adjust accordingly. If you cannot maintain good posture, exercise and stretching designed to balance you out would be beneficial; seek a licensed personal trainer, PT, Chiro, etc..
After leaving this first critical area, your sciatic nerve goes through the inside of your pelvis and comes out the back side a little South of where your pelvis meets your spine at the sacrum, otherwise known as the Sacro-Iliac joint, passing underneath (*or through) an important muscle in this condition: the piriformis. This muscle is on the back of your pelvis and goes from your sacrum to the top of your leg bone. It is capable of pressing the sciatic nerve tightly against the bone of the pelvis. If the compression is here, hypertonicity in the piriformis is the worst, especially if the sciatic nerve is going *through the piriformis muscle. For both, the challenge is the same, it is just much more difficult if the nerve splits the piriformis.
Now you want good posture and good mechanics all the time so the muscle never overreacts to the strain placed upon it. If the muscle strains the compresses the nerve, the pain is very likely to cause a reflex comtraction of the piriformis, thus initiating a viscious cycle which can become excruciatingly painful.
In the first case, it is only the lower spine which needs to be straight and neutral. Now the whole pelvis needs to be neutral. Any imbalance in the pelvis can cause the piriformis to tighten up, compressing the sciatic nerve, and initiating the vicious pain/contraction cycle. Massage can more directly address the problem tissues, reducing the irritating input into the pain/contraction cycle. Massage can also break up scar tissue and fascial restrictions to help restore postural balance that may not be attainable without some form of bodywork therapy.
Again, for self care, find a good professional to work with: CPT,PT,OT,Chiro, etc. Staying ahead of this, and preventing flare-ups is definitely the way to go.
Thom Gonring, ADMT, LMT, NCBTMB Provider
Director of Education