Many people think sciatica is just something you have to live with. It’s time for a new angle. Often, relief from sciatica pain occurs by releasing tension in the muscles surrounding the sciatic nerve pathway. If you are one of the many people whose sciatica pain is caused or exacerbated by tight muscles, self massage with muscle release tools and learning sciatica trigger points can offer dramatic relief.
Sciatica pain relief exercises
Sciatica pain relief exercises are less about “exercise” and more about applying pressure to specific muscle groups that help relieve tension and remove impingements along the sciatic nerve pathway. You’ll be learning which muscles to target and how to best use muscle release tools to apply direct, prolonged pressure for 30-90 seconds (while taking nice, deep breaths).
What is sciatica?
Sciatica is often considered to be a type of back pain; however, it is actually nerve pain. The word “sciatica” describes a kind of pain that someone experiences when their sciatic nerve (which begins in the lower back) becomes compressed, inflamed, and irritated. It is estimated that sciatic pain affects as much as 40% of people over the course of their lifetime.
What is the sciatic nerve?
The sciatic nerve is both the largest and longest nerve in the body – it starts in the spinal canal at the L4 vertebra, goes down to the sacrum through S3, travels out towards the buttocks where it passes underneath (or sometimes through) the piriformis muscle, before traveling down the back of the leg all the way to the feet and toes.
What are common symptoms of sciatica?
Common symptoms of sciatica include radiating pain in the lower back that may travel into the glute and down the leg towards the feet. Some describe the pain as a dull ache along the pathway of the sciatic nerve, while others experience more of an electric jolt or burning sensation down their leg. Additional feelings of numbness, tingling, or weakness may also be present on the affected leg. While the pain is typically felt on one side of the body, it is possible to experience sciatica on both sides.
What are common causes of sciatica?
Common causes of sciatica include bulging or herniated discs, a narrowing of the spinal canal (called spinal stenosis), piriformis syndrome, as well as other spinal conditions that impact the natural alignment of the vertebrae and intervertebral discs in the lumbar spine. It is possible for other conditions to seem as if you are experiencing sciatic pain down the leg, such as SI joint dysfunction and IT band syndrome. In most of these scenarios, the piriformis muscle, deep in your glute, plays a major role in sciatica pain.
Because of the many different possibilities, it is important to consult with your healthcare provider to determine the true root cause of your pain so that you can create an appropriate treatment plan and corrective exercise routine to make long-term improvements and get relief from sciatic pain.
How can I prevent sciatica pain?
While some causes of sciatica may be linked back to genetics, the way that you live your life and take care of your body can also have a really big impact on the likelihood of developing sciatic nerve pain. Keeping your body strong and aligned in good posture allows the muscles, bones, joints, discs, and nerves to function properly and reduce the risk of pain or injury.
The connection between our muscles, body alignment, and sciatic pain
Being in good alignment helps your body function at its best and reduces the chances of experiencing pain, like sciatica. Your muscles are what hold your bones, joints, and spine in good posture as you go about your life – whether you are sitting down, out for a run, picking up your kid, working out, and more.
As we move through our lives, muscle imbalances may develop – perhaps from past injuries, accidents, sitting too much, single-sided habits, sporting activities, you name it – and this changes how our body is aligned. Misalignments can lead to gradual wear and tear setting in and may eventually result in pain.
Focusing specifically in the lumbopelvic region where the sciatic nerve originates, muscle imbalances can hold the pelvis in a twisted position, where they may:
- Affect the alignment of the vertebrae in the lumbar spine
- Change the distribution of pressure across the intervertebral discs
- Reduce space in the spinal canal for the nerves to travel
- Make the lumbar facet joints and/or SI joints unhappy
- Cause the muscles surrounding the lower back and pelvis to tighten up (especially one specific troublemaker: the piriformis. We’ll be focusing heavily on that one)
Each of these things can lead to injuries and/or added compression being placed on the sciatic nerves to cause pain – but we don’t want that!
If you are currently experiencing symptoms that resemble sciatica, I'll share some of my favorite sciatic pain relief self massage exercises that you can try to see how it may help you out along your healing journey.
What are sciatica trigger points?
A “trigger point” is a contracted piece of muscle tissue (commonly known as a muscle “knot”) that exists even when a muscle is at rest. Pressing on this area will trigger a pain response locally in that area and may also cause pain elsewhere in the body, which are known as referral patterns or referral pain.
When describing a trigger point, it is more common to see it be described as within a certain muscle (e.g. piriformis trigger point). When the term “sciatica” is used to describe a trigger point, what someone likely means is actually the pain referral pattern mimics that of sciatica. Due to the proximity of the piriformis muscle to the sciatic nerve, what is actually a “piriformis trigger point” may also be referred to as a “sciatica trigger point.”
How to do self massage for sciatica pain relief
I recommend exploring the following muscles with self massage techniques using a ball or massage tool to help release muscle tension, improve your body’s alignment, decrease compression around the sciatic nerve, and reduce your pain.
For each of these releases, you will likely need to explore along the length of each muscle to find those tighter spots on your body, with a ball or massage tool. Once you find a tight spot, rest in that place (with pressure on that spot) for somewhere between 30-90 seconds (based on your comfort level). Focus on breathing and relaxing that muscle.
After releasing that spot, you may decide to move the ball or tool to a different area of the same muscle, or move to another area and repeat the same process: direct and prolonged pressure with deep breaths for 30-90 seconds.
While self massage for sciatica pain relief may hurt, it should be more of a “hurts so good” kind of feeling during and after the release. The pain should start decreasing after 30 seconds; if it doesn’t move the tool to a different spot. If at any point you feel a large increase in pain that lingers after the release, you may want to reduce the intensity of the pressure and/or explore a different spot along the muscle. If that increased pain does not go away, please stop and consult your healthcare practitioner.
Self massage for sciatica on the piriformis
The piriformis is a small, yet very important, muscle to address for sciatica pain relief. This is because the sciatic nerve actually passes underneath this muscle deep within the glute area before it travels down the leg. If the piriformis muscle becomes too tight, it may compress the nerve and cause sciatica-like pain; this is one of the reasons these spots on the piriformis muscle are sometimes referred to as sciatica trigger points.
While the piriformis lies underneath the larger gluteus maximus, it is still relatively close to the surface of the body. This helps make the muscle easier to access by using something like a foam roller, lacrosse ball, or a massage therapy ball.
These “X”s indicate the location of the trigger points (press here!), and the red areas indicate where the trigger points refer pain (hurts there!)
Self massage for sciatica on the iliopsoas
The iliopsoas muscles are our body’s main hip flexors and also play a large role in supporting the alignment of the lower back and pelvis. Due to its connection points in the lumbar spine, tightness in this muscle can create downward compression on both the joints and discs in the lower back. If left unaddressed for a longer period of time, this may begin to affect the health of these structures and contribute to sciatica due to a disc injury or pinching of the nerve.
Another reason to release the iliopsoas is due to the effect that a tight hip flexor has on the piriformis muscle. The body wants to be in balance, so tension in the front of the hip can cause the muscles on the back side of the hip to tighten up, playing a game of tug-of-war with each other. We already know that a tight piriformis can compress the sciatic nerve and cause pain. When the iliopsoas is also tight, we have a double whammy for potential sciatic pain.
Self massaging the iliopsoas is more challenging than you might think. Unlike the other muscles discussed in this article that are closer to the surface of the body, the iliopsoas is deeper within the core of the body. Because of this, a lacrosse ball is likely too small to even reach this muscle. Using a larger hip flexor release ball can be a little better to reach the general area; however, the most effective way to self massage the iliopsoas is with an iliopsoas release tool designed specifically for that area of the body.
Take a look inside the body to see how the Hip Hook – a psoas release and iliacus release tool – is able to access and release these deeper psoas and iliacus muscles.
Self massage for sciatica on the gluteus medius, gluteus minimus, and tensor fascia latae
This group of muscles – responsible for moving the hips in many different ways and providing stability to the pelvis – tend to be tighter on people who are experiencing pain from sciatica. When these muscles hold tension and do not function properly, it causes other areas of the body to compensate. This becomes the perfect opportunity for the development of muscle imbalances, misalignment of the spine and pelvis, and the potential for sciatic pain over time.
Located on the outside surface of the pelvis, each of these muscles are easily accessible using a lacrosse ball (or similar). You’ll start off laying on your side with a massage therapy ball of your choice underneath you, where you can then angle your torso forward or backward to target the tensor fascia latae (or TFL), gluteus medius, and gluteus minimus muscles.
These trigger point pain referral patterns can mimic the sciatic pain even though the nerve may not be involved, because the muscle knot refers pain to a different spot.
Self massage for sciatica on the spinal erectors and quadratus lumborum
The spinal erectors and quadratus lumborum muscles make up the backside of your “core” and are responsible for moving, stabilizing, and protecting the lumbar spine. Tightness and weakness in these muscles affects a person’s ability to align their pelvis in a safe position when performing their daily activities, increasing the risk of injury and sciatic pain.
For those already experiencing sciatic pain, these muscles like to tighten up to protect the area. However, this can create more compression in the lower back, prevent natural movement of the spine and pelvis, and may increase pain.
The lower back spinal erectors connect to the sacrum and iliac crest and run up each side of the spine along the spinous and transverse processes before inserting into the ribs. The quadratus lumborum are deeper muscles underneath the erector spinae that attaches to the top of the pelvic bone (or ilium), the bottom of the 12th rib, as well as the outside of the transverse processes of the L1-L4 lumbar vertebrae.
While a lacrosse ball may be large enough to reach the spinal erectors, it may be necessary to use a slightly larger massage therapy ball to reach the quadratus lumborum, using pressure in the spots marked with an “x” in the image.
Frequently asked questions about sciatica pain relief
What triggers sciatica?
Sciatica is a type of nerve pain that is triggered when the sciatic nerve becomes compressed, inflamed, and irritated. This is typically caused by conditions such as tight muscles, a herniated disc, degenerative spinal conditions, or misalignments of the vertebrae and discs of the lumbar spine, among other potential causes.
How do I get relief from sciatica pain?
To relieve and improve sciatic pain, you must relieve the pressure that is being placed on the sciatic nerve. One way this can be achieved is through releasing tension in the hip, glute, and lower back muscles.
However, it is important to understand the actual root cause of the issue, which may be closely related to the alignment of the lumbar spine. When the spine is out of alignment, injuries and pain are more likely to occur.
When the spine is in alignment, the bones, joints, discs, nerves, and muscles all work better together. Improving spinal alignment can be achieved through corrective exercises (including muscle release, strengthening, stretching, and mobility).
How do I massage sciatica trigger points?
Applying direct, prolonged pressure to trigger points in the piriformis, as well as trigger points in other related muscles (such as the iliopsoas, gluteus medius, tensor fascia latae, and quadratus lumborum) may help to relieve tension and ease restriction around the sciatic nerve. Pressure is better than rubbing in this cae: rubbing can actually irritate the area and increase pain.
Massaging a tight piriformis muscle may create a sciatica-type pain. This is because the sciatic nerve actually passes underneath this muscle deep within the glute area before it travels down the leg towards the feet.