Low Back Pain and Sciatica Massage Professionals -- Institute for Integrative Healthcare Studies

This article will focus on the link with low back tension and sciatica and look at ways to help clients suffering from both painful conditions.

To help clients who are experiencing clients who are suffering from low back discomfort, it is crucial for massage therapists to recognize the connection between back tension and sciatica issues. Most of the time lower back discomfort and sciatica ailments are linked.

The definition of low back pain

The Lumbar spine comprises five bones called vertebral. The bones within this spinal segment are larger than the vertebral bodies that can better support the weight of the body. The majority of the body’s weight is carried by the Lumbar 5 (L5) and Sacrum (S1) joint. When more weight is placed on this joint, the forces of compression also rise. A study published in the Journal of Biomechanics published in 2015 revealed that compression in L5-S1 increased from 46-52% during the task of holding loads and between 80-147 percent without any load on hands as the weight of the person increased from 51 to 119 kilograms. (1)

As the compressive force increases on the lumbar spine muscles and other structures need to be stronger to stand up to the increasing pressure. This strains ligaments, muscles, and tendon. Sensory as well as motor nerve supply can be affected by this area. In the event that it is the case that the L5 spinal nerve is impinged or motorized, sensory or motor impairments can be observed in the knees, hamstrings and calves , and feet.


In the past it was believed that it was believed that the RICE method of rehabilitating injuries was the most common method of aiding in the treatment of musculoskeletal pain. The word RICE can be a mental image that indicates Rest Compression, Ice, Compression and Elevation as the primary way to recover from injury. Numerous health specialists are adding “Protect” to make the mnemonic PRICE. they can help protect injuries with bandages and splints.


Today, a lot of health professionals have changed their views on RICE as a standard of medical treatment for injuries. Many suggest slowing down movement as quickly as is possible following injury is the best method to improve back health. The mnemonic MEAT originated from this concept. It is a reference to “Movement and Exercises, Analgesics, and Therapies.” The addition of movement keeps the scar tissue from creating limitations within the injured area while the muscles recover.

Defining Sciatica Conditions

Sciatic nerve is a massive nerve which originates from the lumbar plexus nerves.

It is said that the Cleveland Clinic describes that injury to the sciatic nerve itself is uncommon, but the word “sciatica” usually refers to the pain sensations from the lower back that radiate down the legs. (2)

Numerous massage manuals further clarify the different kinds of sciatica. There are three major kinds of sciatica conditions that are typically described in massage manuals that are commonly used:

#1: Real Sciatica is characterized by the impingement Sciatic nerve at the Lumbar-Sacral-Pluxus (L4 to S1 root).

  • If the L4 spinal nerve is affected on the medial leg-footarea, reduction in dorsiflexion ankle motion and a decreased knee-jerk reflex.
  • If the L5 spinal nerve is affected it can cause a sensation such as an inability to extend the great toe, as well as “drop foot” observed in gait.
  • If the S1 spinal nerve is affected on the side-leg-foot are diminished, as is ankle plantar flexion, and there is a decrease in the ankle-jerk reflex.

# 2: Piriformis Disorder involves impingement or amputation of Sciatic nerve or between Piriformis and Superior Gemellus muscles, or within the Piriformis fibers themselves.

#3: Pseudo Sciatica includes an impingement on the Sciatic nerve beyond the prior two places, most commonly between Gluteus Maximus and Gluteus Muscles Medius.

Epidemiology (Frequency)

David Davis, et al in the study he released in StatPearls online, present the most current statistics on epidemiology for sciatica diseases. There is a lifetime prevalence between 10-40% for the general U.S. population with peak frequency observed between the ages of 40-49. Workers who are exposed to physical strain are the most likely to suffer from sciatica ailments. (3)

Classic symptoms and signs

  • Lower back /hip discomfort
  • Radicular leg pain
  • Numbness, burning or tingling that is felt in the lower back as well as hips and legs.
  • Leg muscle atrophy or weakness that is felt in the low back hips, legs and lower back
  • Chronic gluteal pain
  • Scoliosis developing later in life
  • Reproductive organ issues as spinal nerves S1 through S5 are linked with the function of the reproductive organ.

Common Causes of Sciatica or Low Back Pain. Sciatica

The most frequent cause of pain in the lumbar or sacral areas are spinal nerve roots impingement caused by an intervertebral (spinal) disc injuries. A spinal disc could be suffering from three different injuries.

  1. The bulging discs are also known as “slipped,” a portion of the spinal disc can swell up and press against the surrounding spinal ligaments, which causes an uncomfortable compression on adjacent spinal nerves.
  2. Herniated discs spinal disc is injured by spinal ligaments and extends beyond its normal space within the vertebral body boundaries within the spinal bone, which causes injury to the neighboring spinal nerves.
  3. Disks that have degenerated spinal disc degrades, and causes the fluid core that lies within it, referred to as the nucleus pulposus to be able to spill out into surrounding spaces and, in the worst case, injure neighbouring spinal nerves.

In addition to disc issues There are many other causes for lower back discomfort and sciatica conditions.

Other causes of low back Pain and Sciatica

Lumbar stenosis that causes an increase in the spinal canal, spondylosis resulting in stiffening and eventually fuse of vertebral joints and spondylolisthesis that is accompanied by spinal displacement of the bone can cause nerve impingement, primarily at the junction of L5-S1.

Furthermore, the dysfunction of the Sacral-Iliac joint could be likely to be the cause of the pain in the lumbar region. Effects of pregnancies on the female body could cause muscles spasms within the lumbar-gluteal system, which can cause pain.

The injury to the spinal cord that results in neurological problems can develop into a complication or be the cause.

If the lumbar-sacral pain is caused by:

  • an impairment of bladder and/or an inability to bowel.
  • Progressive lower limb weakness, or numbness of the upper thighs/groin area

Get medical attention right away seek medical attention immediately, since complications may have developed.

Massage Therapists and their Things to Consider

Functionally, the sacrum functions in two important ways.

  1. First, the sacrum functions as an anchor, securing the vertebral column to the pelvic girdle.
  2. The sacrum is the second organ that transmits tension and gravitational force from upper body to the lower body.

This is due to two reasons that make this bone extremely important when treating back pain and inflammation in the low back and gluteal areas.

I have taught in entry-level education, I am aware that numerous students and general public members might be hesitant regarding receiving massages near the sacrum and the gluteal region. Do not assume consent from the client for this area. Always seek informed consent prior the session. Explain why you want to focus on this area. Make sure your client is aware the musculature in this area affects muscle pain and other muscles.

A massage therapist that is aware of the relationship between the lower back as well as sciatica can address the two areas with care. Stretching the low back and gluteals can be beneficial to the treatment. If one is proficient in cranial sacral therapies, the sacral technique derived developed from this study can help tremendously.

About the Author

Jimmy Gialelis, LMT, BCTMB

Jimmy Gialelis, LMT, is a nationally board certified clinical practitioner who is passionate about helping clients achieving maximum health benefits. As a participant in the Massage Therapy Hall of Fame as well as contributing in the Massage & Bodywork Licensure Exam as a writer of exam items. He also runs a business for continuing education, Advanced Massage Arts & Education as well as a private practice located in Tempe, AZ.