Pseudo Sciatica and Massage

Glute muscles and the sciatic nerve in Denver, Colorado
Several months ago I saw a client, J, an otherwise healthy and fit young male, who came to me in a lot of pain. What started as some mild hip pain a couple weeks before had turned to shooting, burning pain from his buttocks, all the way to his feet. Sitting at work was painful, walking anywhere was painful and difficult enough to use the surrounding furniture for support. He couldn’t even get more than a few hours sleep at a time, the pain was so bad.

I’d seen this before, and it seemed to me that J probably was suffering from a case of pseudo sciatica, also known as piriformis syndrome.

What is pseudo sciatica?
Well, first, what is sciatica? Sciatica is a painful condition affecting the sciatic nerve, which runs from your spinal cord in your low back (L4-S3 if you’re interested the specifics!), and down the back of your legs. This nerve is responsible for the feeling and movement in your buttocks, back of your thighs (but not the front!), and the entire lower leg and foot.

Some common sciatica symptoms are:

  • Pain and burning that shoots down the back of your leg.
  • Leg pain that is worse when sitting.
  • Numbness or weakness in the leg that makes it difficult to move.

These symptoms are caused when the sciatic nerve gets impinged and irritated at the nerve root, which is where it breaks off from the spinal cord and begins it’s journey out of the spine and down the legs.

So what does this have to do with pseudo sciatica?
“Fake” sciatica presents all the same symptoms as true sciatica. But the difference is that the impingement of the sciatic nerve isn’t occurring at the root, but later on down the line. Usually this happens in the glutes, where the sciatic nerve can get pinched when the piriformis gets tight, hence the alternate term “piriformis syndrome”. Thankfully, because the impingement is caused by muscles, this makes piriformis syndrome easier to treat with massage therapy than true sciatica.

As for J?
When I worked with J, we spent the entire massage on his lower body where the sciatic nerve is located. Like I suspected, his muscles were so tight, they were irritating  the sciatic nerve. The majority of our work was spent on the hip and glute muscles. When J left that day I gave him instructions for home stretches.
Over the course of the next couple of days, his walking and pain levels began to improve. By the time I saw him again the next week, he could walk and work again, and had finally gotten several full nights of sleep. The pain he’d been living with for weeks had almost gone away completely with only one session.

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