Hopefully, if you are a massage therapist reading this, you already know where the sciatic nerve begins and where it ends. I feel for your clients if you don’t. For those of you who have come across this because you are suffering from sciatica or know someone who is I think you will find this post to be helpful. Here’s a brief little interpretation from one of my old clinical books, Clinical Pathology.

Not word for word but I’ll sum it up for you. Sciatica involves motor deficits along the course of the sciatic nerve. Fibers from this nerve emerge from the intervertebral foramin of the lower lumbar and sacrum region and go all the way through the gluteal and posterior thigh region to the popliteal fossa of the knee. From there, the nerve devides into the posterior tibial nerve and the common peroneal nerve. These go all the way down into the plantar part of the foot.

Sciatica can be caused by a herniated lumbar disc, a vertebral canal tumor, fractured or abnormally shaped vertebra or even a bone spur. A growing fetus can put pressure on the nerve, and I know this sounds gross but impacted feces in the colon or a spasm in the piriformis muscle can cause sciatica. I think the most common causes are the piriformis and lumbar vertebrae issues.

Signs of sciatica are graded on a three-point system based on where they are experienced.

• Grade 1 in the gluteal region
• Grade 2 to the posterior knee
• Grade 3 to the foot

I strongly suggest massage, movement, and hydrotherapy to aid in the recovery of sciatica. If the client is complaining of sciatica but doesn’t notice that the pain goes any further than the gluteal muscle you may want to consider some trigger point therapy in the gluteus medius. This is sometimes referred to as “False Sciatica” and myofascial release is needed.

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