Sciatica nerve neuralgia can be the result of compression of the S1 spinal nerve as well as due to the compression
of the sciatic nerve by over-tensed piriformis muscles. If patients with symptoms of sciatica have the ability to bend forward
without awaking pain, most likely the sciatica neuralgia is the results of
The Causes for Accumulation of Tension in the Piriformis Muscles
1. Due to spondylosis, including herniation
of disc, spinal nerves can be irritated (please do not confuse irritation of the spinal nerve with compression of the spinal
nerve.) Irritation of the spinal nerves that provide innervation to the piriformis muscles (S1 spinal nerve) will cause a
gradual accumulation of tension in these muscles, to the point that they will compress the sciatic nerve.
2.
Physical overload of the muscles such as vigorous exercise, job performances that put too much static load on the piriformis
muscles, hormone changes, exposure to toxins, physical and/or psychological trauma, etc.
Once, I presented to a group of doctors on medical massage and I mentioned the importance of medical massage
treatment in cases of sciatic nerve neuralgia. I also pointed out that in many cases, herniation of the intervertebral disc
does not play the main cause for this difficult clinical picture . One of the young doctors who attended my presentation said
to me “According to you, many spinal surgeries are performed unnecessarily,” to which I replied, “This is
true.” This young doctor asked me the following question: “How can I explain that after surgery this terrible
irradiating pain to the extremities disappeared?” I replied, “Under total anesthesia, all muscles drop any tension
they were holding. Thus, if the cause of this neurological picture was over-tensed piriformis muscles, the post-anesthesia
patient experiences immediate relief from the shooting pain to the lower extremities.
Massage therapy procedure in cases of sciatic neuralgia is directed at reducing the tension
in piriformis muscles, which in turn will impinge/compress nerve less, as well as to eliminate trigger points that possibly
can be developed on the pathways of sciatica nerve and branches.
Boris Prilutsky, MA
