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August 13, 2004

More On Sciatic Pain

I have written previously about low back pain with sciatica-like symptoms. A new client presented today with pain extending from her low back through her gluteal muscles and down both the front and back of her leg. Her mobility was impeded to the point that she could not bend her knee or sit without pain.

This client also had a history of lumbar disk injury which she had treated with surgery. This immediately raised a red flag in my mind concerning her condition. I asked if she had seen her doctor. After confirming that she had, along with having extensive tests run, she described this pain as different than what she experienced with her disk injury.

To start the session, I gently palpated the afflicted side. The piriformis muscle was highly reactive and the client reported an "8" on the pain scale (1 being no pain, 10 being unbearable). With diligent communication, I worked to stretch the attachment of the piriformis at the greater trochanter with my thumbs while I applied heat to the insertion and the belly of the muscle. This reduced the client's pain significantly. I was then able to use the blade of my forearm and then my elbow to address the trigger points in the great muscles of the hip. This resulted in further relaxation of the hip muscles on both sides.

Then I had the client lay on her side so that I could access tensor fascia lata, the muscle that controls the iliotibial band of the leg. This also allowed alternate access to the gluteus medius and minimus muscles which lay beneath gluteus maximus. Gluteus minimus proved to be highly reactive.

Because we were running out of time, I switched to craniosacral therapy. I didn't want the client's protective mechanisms to become engaged again soon after the massage. Craniosacral therapy is a good tool for soothing the central nervous system and helps the body integrate change.

The client left the session with a just a mild limp. To assist the client with home care, I assigned my standard low back exercises. She was so grateful that she promised to bring her mother who is also afflicted with the same condition.

Posted by linda at August 13, 2004 8:37 PM