Sciatica and piriformis syndrome both create pain in the low back, buttocks, and back of the leg. Often they bring numbness, tingling, or even weakness with them. Sometimes they make simple things such as walking, sitting, or driving a car painful and difficult prospects.
Sciatica refers to pain arising from pressure on the sciatic nerve. This nerve travels from the lower spine, through the buttock, and down the leg to the foot. Disc problems in the lower back, spinal stenosis, and bone spurs are common culprits of pressure on the nerve. Typically, sciatica sends pain signals from the low back down the back of the leg and only occurs on one side of the body.
Piriformis syndrome comprises a set of muscular issues that cause sciatica-like symptoms. It gets its name from the piriformis muscle, which lies underneath the gluteus maximus, and crosses the back of the buttocks. This muscle can get tight, it can press on the sciatic nerve, and it can stress the joint. Sometimes people can have both a bone and a muscle pressing on the nerve.
Generally speaking, massage can help ease pain. In our experience with sciatica and piriformis syndrome, massage helps the tight muscle part of the equation the most. It has much less influence on pain from a bone or disc problem.
If a tight piriformis muscle is the main culprit, massage can make a significant difference in alleviating the pain. Softening the tension can relieve tender spots in the buttocks and referred pain to the leg, back, and groin. It can also ease pressure on the nerve itself and allow the joint to align properly.
If the pain stems from a bone or disc problem, massage may not help as much. At most, in our experience, it allows for temporary relief. Of course, this type of sciatic pain can lead to muscle tension around the nerve pathway that can increase pain. In this case, massage can help alleviate the additional pain and sense of tension. So, massage might still benefit people who have sciatica, just not as fully as it can help those who have piriformis syndrome.
When sciatica arises during pregnancy, the same rules apply. The more the pain stems from muscular tension, the better massage helps. In some cases, however, the pain never fully resolves until the end of the pregnancy.
Massage for sciatica or piriformis syndrome will focus on the posterior hip of the affected side, that is the butt. The therapist may also work the low back and leg depending on specific symptoms and time. The therapist may employ a range of techniques including focused direct pressure massage, light gliding massage, and stretching. Sometimes, the client wears sports attire and does movements along with the massage therapist. Most typically, clients use massage as part of an integrative care approach that also involves their medical team and physical therapist.