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Massage Today
May, 2008, Vol. 08, Issue 05

Sciatica

By Ben Benjamin, PhD

The sacrum, the iliac bone or ilium, the sacroiliac ligaments and the iliolumbar ligament. - Copyright – Stock Photo / Register Mark The sacrum (A), the iliac bone or ilium (B), the sacroiliac ligaments (C), and the iliolumbar ligament (D). Q: Does the term sciatica refer to an impingement of the sciatic nerve?

A: No. Sciatica is a commonly used lay term that simply means a pain down the leg, which might originate from many possible causes.

Side view of SupraSupraspinous ligament. - Copyright – Stock Photo / Register Mark SupraSupraspinous ligament (A) side view. Pain felt down the leg usually is an example of referred pain, which means the pain is felt at a different location than the source of the injury. A severe injury generally causes pain to refer a greater distance than a minor one. Therefore, if a client has a severe low back injury, the pain will often refer all the way to the lower leg or foot. If the client's injury is minor, the pain may refer only as far as the lower buttock or upper thigh. The difficulty in assessing these injuries is that nerves, ligaments and muscles can cause similar referred pain patterns.

illustration showing nerve-root compression. - Copyright – Stock Photo / Register Mark Most clients with referred pain in the thigh and lower leg think they have a pinched sciatic nerve. The sciatic nerve is formed from five separate nerves: L3, L4, L5, S1 and S2. When there is a disc injury, it is likely to compress one, but not all, of these nerves. In fact, such injuries are relatively uncommon, accounting for less than 5 percent of cases of sciatica. More common causes include injuries to the sacroiliac ligaments, iliolumbar ligaments, sacrotuberous ligaments, gluteus medius or maximus muscles, or the L4-L5 or L5-S1 supraspinous ligaments.

If someone does, in fact, have a nerve-root compression, massage therapy can make them a bit more comfortable, but can't relieve the disc pressure. On the other hand, if the pain is due to a ligament or muscle injury, various forms of hands-on therapy can help the person recover more quickly.


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