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Sciatica and Massage

Many people claim to suffer from sciatica but what is sciatica?

Put simply, sciatica is a pain, usually in the back of the leg caused by compression, irritation, or inflammation of the sciatic nerve. The sciatic nerves are the longest and largest nerves in the body, running down the back of each leg and are about the diameter of your thumb.

The sciatic nerve is actually composed of four or five smaller nerves that leave the spinal cord from the lower spinal column, join together and then travel down each leg. It then divides into numerous smaller nerves that travel to the thigh, knee, calf, ankle, foot and toes. When these nerves are irritated or affected by the inflammation of nearby soft tissues, then this is referred to as sciatica.

There are several reasons why the sciatic nerve could become compressed, entrapped, or irritated. In “true” sciatica, the nerve roots can be compressed by herniated, degenerated or displaced lumbar spinal disc(s). This can be exacerbated by tight muscles and soft tissues in the lower back, buttocks or leg.

sciaticaThere are also other conditions which can mimic sciatic symptoms such as Piriformis Syndrome where the sciatic nerve is entrapped by the piriformis muscle in the buttocks. Piriformis Syndrome is sometime referred to as “back pocket sciatica” as pressure on the piriformis muscle and sciatic nerve can be caused by sitting on a wallet in the back pocket of a person’s pants. Another problem that can imitate sciatic pain is trigger points in the Gluteus Minimus muscle. The trigger points in this muscle can refer pain sensations down the back of the leg along the path of the sciatic nerve and also on the outside of the leg.

People with sciatica suffer from a wide range of symptoms. The pain may come and go at different times, it may be a constant problem and then it may subside for hours or days for no apparent reason. Some people may feel only a dull ache travelling down the back into the upper leg. For others, it may be intense sharp shooting pains all the way down the leg into the foot and toes.

Many factors can influence the pain of sciatica. If the sufferer sits in one position for long periods of time then the pain can increase. Long distance drivers and computer operators are particularly susceptible. Exercising, or even simple things like walking, bending, twisting or standing up may be difficult and painful. For some, the pain may change from side to side or be present in both legs. For others, back pain may appear before the sciatica emerges. In some severe cases, sciatica can impair reflexes, or result in the wasting of the calf muscles.

Treatments for Sciatica
The medical approach to dealing with sciatica is to treat the symptoms. This may include using painkillers, muscle relaxers or anti-inflammatory drugs such as NSAIDs . Traction, physical therapy or injections directly into the nerve roots may also be used. In severe cases, Surgery (such as microdiscectomy or lumbar laminectomy) is used to help relieve both pressure and inflammation.

  
Massage Therapy
Massage Therapy and Bodywork can help Sciatica, Sciatic Nerve Pain, in particular the conditions which mimic sciatica such as Piriformis Sydrome. Massage therapy can relaxes muscles, releases trigger points and abnormal tissue adhesions, and improve posture to relieve the pressure on nerve roots and other sensitive structures.

Other Manual treatments (including physical therapy, osteopathic, or chiropractic treatments) can help relieve the pressure. Chiropractic and Osteopathic techniques are often used in conjunction with treatment by a Massage Therapist.

Use a Tennis Ball
The knots in the muscles of the hip and buttock can be effectively treated with a tennis ball. Simply lie on a tennis ball such that it presses on deep, sore points and just wait for the feeling to fade. However please be aware that the piriformis muscle is so unusually reactive and the use of a tennis ball to massage the piriformis needs to be gentle and conservative.

Jump in the Spa to Relax the Area with Heat
Whether the pain is caused by the crushed sciatic nerve itself, or just by tight muscles, the muscles need to relax. Hot tubs, with jets, are ideal for sciatica.

Check Your Posture
The types of sciatica that are related by excessive sitting may be influenced by the ergonomic design of work station and/or chair. It may be worth experimenting with your chair and the layout of your work station. A simple option is to use a timer to remind yourself to get our of your chair at regular intervals such as every fifteen-twenty minutes.

By Richard Lane

Cellulite Massage

Cellulite – the mere mention of the word can bring about a highly negative reaction in some women. There are many creams, body wraps and treatments that are claimed to bring about reduction in or an elimination of cellulite, yet much of the money that is spent on cellulite is simply wasted as there is little evidence that they work. Some people claim that most of the research that is reported is paid for by companies with an interest in promoting favourable aspects of results and is not truly scientifically independent.

Abdominal massageThere are also many massage therapists who promote that their massage techniques can bring about a reduction in cellulite and they claim that there are studies that support that cellulite can be smoothed and reduced by a cellulite massage.

What is Cellulite?
Cellulite is not an actual disease but a condition of bulging fat cells that lead to an appearance of bumpy looking fat on the skin. In some circumstances the fat cells expand to the point that they result in the bending of collagen fibres surrounding them which gives rise to a puckered skin appearance. There are still some arguments about how the fat cells originate; some say that it is the result of a build up of metabolic waste due to ineffective lymphatic drainage and/or poor circulation, others claim that it is more environmental (tight clothing for example) or diet related. However, aspects that are generally agreed upon are that the incidence of cellulite is hereditary and the thickness/configuration of the dermis plays a significant role. For example, men who typically have a cross-hatch type pattern of connective tissue beneath the dermis, are much less likely to be affected with cellulite.

Treatments for Cellulite
Exercise and Diet
Although there are so many health reasons for having a good diet with lots of fresh and natural foods along with regular exercise, unfortunately these will not “cure” cellulite. If you lose weight, then there may be a reduction in the levels of fat that occurs as cellulite but for most women, genetics are the overriding factor and the cellulite appearance can be considered as being predetermined by her genes.

Creams
Probably as much money is spent on creams as any other treatments but there is little evidence that they offer long term benefits. The proposition that a topically applied cream will penetrate the skin and act on the fat deposits, is hard to contemplate particularly as the skin is normally considered as a great barrier.

Some people do feel that regular application of creams does reduce the appearance of cellulite although it is probably the case that the cheaper creams are as good as the expensive creams that contain wild and exotic ingredients. This is particularly relevant if it is possibly the mere act of massaging the cellulite that may be responsible for the transient improvement in appearance.

Endermologie
For women who have spent time and money on cellulite cures, then the phrase Endermologie will be familiar to them. There are many clinics offering Sydney Endermologie or Lipomassage or the like. Endermologie is claimed to work by suctioning the skin with a vacuum and then applying a type of deep tissue massage using a set of rollers.

This type of process which can break up adhesions and fibrous bands, can improve the appearance of the skin for some women. However, the effects are not permanent and the cost of regular sessions can mount up very quickly.

Cellulite Massage
Whilst massage therapy has numerous benefits for the body and the mind, there are some therapists who claim that their massage will bring about improvements with respect to cellulite. For example, they wildly claim that deep tissue massage can break up the fat deposits and eliminate toxins. Lymphatic drainage may assist in removing oedema and accumulated fluid in cellulite affected areas but the relationship between fluid elimination and reduction in cellulite has never been proven.

  
Other Treatments
There are many other devices that are available with differing degrees of success and if you are interested in any of these, then it is a good idea to spend a little time doing research before you spend your money. And it is always good to be sceptical about suppliers’ claims.

One treatment that has been approved by the FDA that may offer some benefits is Vela Smooth which combines Bi-Polar Radio Frequency, infrared light energies, plus negative pressure and tissue manipulation to smooth the skin. Again though if you read independent online reviews then some women have claimed success whereas others have felt that they have wasted money and had their raised expectations dashed.

If you are thinking of trying a treatment, be it a cream, a machine or for sessions of lymphatic drainage massage for reducing your cellulite then it is advisable to shop around and do your research beforehand and always be wary of pre-paying large sums of money for treatments without guarantees of success.

By Richard Lane

Should Massage Hurt?

Ask 10 therapists this question and you are likely to get 10 very different answers. Some therapists do not believe that massage should be painful, ever, and if you are in any sort of discomfort then you are being massaged too hard. Other are at the opposite end of the spectrum and if you are not squirming, squealing and wriggling as they beat the knots out of you then they are not going hard enough.

My answer….it depends.

If you are purely after relaxation massage at a day spa or for stress relief then you would be looking for a massage that is be blissful and pain free. If you have never had a massage before then this is probably the end of the pain spectrum that you can reasonably expect to receive.

You should not feel sore or uncomfortable that day (or the next morning) and any pain is an indication that the therapist wasn’t listening to you or your body.

However, I’m sure I gave one of those massage in 2004.

Deep Tissue massage of a woman's thighPeople who book in to see me are generally after remedial, deep tissue or sports massage and for this group of massage recipients then some degree of discomfort both during and after the massage should be anticipated. Sometimes you have to take one step back to move two forwards.

If you are suffering from a sore back or a stiff neck then myofascial restrictions and adhesive scar tissues need to be worked. Polishing the skin just isn’t going to cut the mustard even if it does calm the nervous system and relax the sympathetic nervous system. You need to get into the muscles (and other soft tissues such as ligaments and fascia) and disrupt their current condition in order to obtain the response that you are looking for.

Now although a deep tissue massage sounds as though it should be excessively painful, this is not necessarily the case. Deep tissue merely means working the deeper levels of tissue, working through superficial layers of fascia and muscle to achieve a change in the structure of the deeper tissues.

But while it needn’t be excessively painful, in reality it is almost always the case that it can be uncomfortable. Personally I do take issue with therapists who say that deep tissue massage should never hurt and feel that either they have never experienced genuine deep tissue massage or they are doing it wrong.

By the same token, though there are therapists who work at such a pressure and intensity that a client is literally bruised and in more discomfort than when they started the massage. “No pain – no gain” may the mantra of the therapist. This doesn’t sit comfortably with me but if it works for them and their clients then so be it. So long as they are genuine with their intentions, explain how they will work and warn their clients how they will feel after the massage then that’s ok with me.

It’s just not the way I work.

  
I like to work within the clients pain threshold so that whilst it may be uncomfortable and bordering on painful (when I consider it to be appropriate), it should never be so heavy that they are wincing and flinching on the table. By the way, the level of pain threshold does tend to increase the more massage you receive and arguments have been made that this isn’t necessarily a good thing (eg needing more and more pressure to achieve the same response is almost an addiction).

Ultimately it is up to you to find a massage style and therapist that suits you. If you have never had a massage before and you are in pain during the massage, then speak up. Similarly if you know what you want and the therapist is one of those who insists on not hurting you at all then maybe you need to find someone else who can give you the type of bodywork you are after.

By Richard Lane


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