Sciatica symptoms caused by Trigger Points
Sciatica is defined as nerve pain caused by irritation of the sciatic nerve. Sciatica is a common condition that affects millions of people worldwide.
The sciatic nerve is the thickest nerve in the body (aprox. 2cm wide), it originates at the lower back/sacral area (L4, L5, S1,S 2, S3) and travels through the gluteal area and the posterior compartment of the thigh before it splits into the tibian nerve and the common peroneal nerve.
The nerve can get compressed or irritated anywhere along its path, either by bones or muscle/fascia, causing the common sciatica symptoms.
This is where it becomes interesting.
Although the nerve can get compressed at the spine level by a slip disk or an overgrowth of bone on the spinal bones (bone spur), the nerve can also get irritated and compressed by muscle/Fascia on its path.
This last one is a more common presentation and it also has a much better prognosis since we can effectively release the pressure with non-invasive soft tissue release treatment.
The fact that in a lot of cases sciatica can be relieved with a few treatment sessions is not always common knowledge means that people with this presentation usually aren’t given enough information about this treatment option.
Let’s focus on the types of sciatica that we can release with soft tissue therapy. In these cases sciatica is caused by a tight muscle/Fascia that irritates the nerve.
Usually these muscles have Trigger Points that we can release to alleviate the symptoms. These Trigger Points can be caused by overuse, injury, poor postural patterns, weakness, stress etc.
Trigger points or knots are hyper-irritable spots within a taut band of muscle. They can cause pain locally in the area where they’re located and referred pain in other parts of the body. When trigger points form in muscles around the sciatic nerve, they can irritate the sciatic nerve, leading to sciatica.
Symptoms of sciatica caused by trigger points include:
- Pain that radiates down the back of the leg
- Numbness or tingling in the leg or foot
- Weakness in the leg or foot
- Pain that worsens with prolonged sitting or standing
- Difficulty walking
As we mentioned above, trigger points can be released with soft tissue therapy, in our case we use a combination of Myofascial release and Trigger Point work.
Let’s have a look at the muscles that can cause sciatic nerve irritation and therefore sciatica that can be addressed with non-invasive treatment.
These are often overlooked and therefore untreated:
Pririformis: Often referred to as Piriformis syndrome. Inflammation or Trigger Points in this muscle can cause compression and irritation of the sciatic nerve, presenting with pain and or numbness in the buttock and down the back of the leg.
Quadratus femoris: Injury or inflamation to the quadratus femoris can cause groin pain and gluteal pain that can radiate posteriorly down the leg, presumably by irritation of the sciatic nerve either from hematoma or edema.
Adductor magnus/biceps femoris: As the sciatic nerve travels down the back of the thigh, it passes through the adductor magnus and outer head of the hamstring called, bicep femoris. The sciatic nerve can get compressed between these two muscles.
Gemillus/oburator internus complex: Gemellus and obturator muscles can also cause compression of the sciatic nerve.
Hamstrings: In their attachment at the ischial tuberosity (hamstrings syndrome). Thought to be tendinopathy at the ischial tuberosity there might be involvement of the sciatic nerve as well.
How do we treat these muscles and alleviate the sciatic symptoms?
In our clinic we use a combination of different techniques, Trigger Point work and Myofascial release between others, to release soft tissue restrictions and Trigger Points.
We assess the body as a whole interconnected unit and look for postural patterns or imbalances that might point towards a particular issue that might be causing the sciatica or contributing towards it.
During the treatment we localise the painful area and the origin cause and treat it accordingly.
As a very effective technique, trigger point work, we apply steady pressure over a period of time. This dissolves the trigger point releasing the symptoms associated with it.
There is never a straight answer when it comes to the human body and sciatica is no different. The presentation will be unique in every person and will require a different approach for everyone, that’s the magic of body work and soft tissue therapy and trying to constantly solve the puzzle is what keeps us therapists engaged and humble!
If you are experiencing sciatica it’s important that you get it properly assessed by a professional. Don’t be scared to seek different opinions from different specialists and sticking with the one that gets you the best results.