Sciatic nerve pain feels like shooting leg pains that travels right down the entire leg. Ever have your dentist hits a nerve in your tooth when drilling? Eeek! Not nice! Now imagine that in your legs sporadically throughout the day! It can get you while you bend down, sit for long periods of time and can often be accompanied by low back pain.
A great character came into the clinic a few weeks ago, easy going and loves the chat. He was 60 years old and worked as a very experienced and well sought after manual labourer working on some fascinating jobs.
A few weeks ago he lifted a heavy bit of material and did something to his back. To be precise he strained his Quadratus Lumborum (QL) muscle in the lower back. You would probably describe it as something like: “I tweaked my back”, “I did something to the spine”, “my back went out”, “I must of pulled something”, and these statement would all be right, because it’s the sensation you feel in the area!
Ideally he should have come to visit within the few days that the incident happened as the longer you leave something the more mobility you lose and you begin to chase problems. If it’s sore to bend to one side you will choose to always use the other side and then that gets overworked and maybe it also gets sore because of this compensation and you get a cascade of pain effect! Better to treat it early and not cause extra problems.
So the session was to fix his back pain. I had him lay face down on the plinth and was checking his posterior chain of muscles (the back of the body). Now a healthy muscle should not hurt when you press on it but when I pressed on his glutes (bum muscles) he let out a sharp ‘Yelp!’
“That shot right down to my foot!”, he gasped.
“Have you felt that pain before?”
“Yeah, about the last 14 years! When I stand on my feet all day, then around four o’clock I feel it right down the back of the legs. It’s knackering!”
“Did you ever get it checked out? ”
“Yeah, I went to a few doctors when it happened, got x-rays and tests and they said there was nothing wrong, so that was that. I just got on with it!”
And that’s what people DID all those years ago and STILL DO even today!
Most people are not aware of the pains and problems that muscles which are in trouble are responsible for. What’s worse is that most of the medical community, like your doctor, consultant and GP are also unaware of this. It can be a straight forward fix for Neuromuscular Therapists who specialise in trigger point therapy.
WHAT CAUSES SCIATIC NERVE PAIN AND HOW TO CHECK FOR IT?
True ‘sciatica‘ is usually a result of a disk problem in the spine. We know that his back was clear from structural problems as his doctors scans attested. I did a slump test to check for nerve sensitivity which he tested negative for. A straight leg raise tested positive, as as did a muscle activation test of the piriformis muscle in his glute for the pain. So it would appear to be a case of ‘Piriformis Syndrome‘ and not ‘sciatica‘. The sciatic nerve starts in the lower spine, threads its way between some very powerful muscles in the bum (piriformis is the main culprit), down the leg and all the way into the foot.
HOW SCIATIC PAIN CAN COME ABOUT?
But what happens if a muscles called the piriformis muscle gets a sudden jolt? It can overstretch and then tighten up. It could happen when you miss a step on a flight of stairs or a ladder and then landing awkwardly on your leg, or even slipping on ice and landing on your bum. The muscle knots up, never relaxes and then strangles the sciatic nerve which passes through it. If this happened, the more you stretch the piriformis muscle when you bend or move, the more pain you will experience.
HOW WE SOLVED a 14 YEAR OLD SCIATIC PAIN PROBLEM
First things first he came to me with a back problem so I began working on that and he responded very quickly and we sorted that which was great news for him as he could get back to work. Then I began work on the powerful muscles in the glute which were strangling the sciatic nerve and the cause of his sciatica pain. I use a very simple system of pain feedback with clients so they are never in excessive pain when I work with them. Too much pain and they clench the muscles which I want to release! We talked back and forth through the whole session on how much pressure and pain he was experiencing as I worked, as well as shooting the breeze about his interesting work, my own work and talking him through what I was doing to fix his long standing problem. He was fascinated at what I thought his problem was, “the body is amazing!” is a phrase I hear very often on my plinth.
WHAT WAS THE RESULT AFTER TREATMENT?
We got a good amount of work done in the first session and most of the major muscles released in his left glute. Six days later he came back full of smiles and said his back was 90% better straight away after our first session and to his amazement said
My left leg is better than I can remember it in over 14 years!
I’m not going to lie that type of report always gives me a big grin and makes me love this work!
In the second session we finished off his back issue and then found it much easier to do a deeper clean out of the piriformis and the other very deep muscles in the glute and around the hip joint.
WHAT NEXT FOR THIS CLIENT?
Well we have to work our way down to the back of his left leg (hamstring) and also begin working on the right glute and leg which has the exact same problem. I’ve given him a toolkit of mobility drills and soft tissue release techniques using some tools which he can do to keep the hips and glutes nice and free in the future should he experience any tightness again.
Another successful job done!