Sciatica Massage
Interview & Pain Mapping
Step 1: Check the Location
Ask the person exactly where the pain starts and where it goes.
Sciatica Signature: The pain is usually unilateral (on only one side) and travels from the
lower back or glute, straight down the back of the thigh, and often past the knee into the
calf or foot.
The Feel: They will often describe it as a sharp, burning, electric shock, or a constant deep ache,
rather than a dull muscular soreness.
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Postural & Gait Observation
Step 2: Watch How They Move
Observe them as they walk or stand up from a chair.
Antalgic Gait: Look for a limp where they spend as little time as possible bearing weight on the
painful leg.
Shifted Posture: They may stand with their torso slightly leaned away from the painful side to
relieve pressure on the nerve roots in the spine.
[Link] Straight Leg Raise Test (Lasègue's Sign)
Step 3: Physical Movement Check
Have the person lie flat on their back on a comfortable, firm surface.
Slowly lift their relaxed, straight leg up by the ankle.
Positive Sign: If they feel a sharp, shooting pain radiating down the back of the leg between 30
degrees and 70 degrees of elevation, it strongly indicates sciatic nerve irritation. Pain that only
occurs higher up (above 70 degrees) is usually just tight hamstrings.
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Check for Neurological Signs
Step 4: Check for Muscle Weakness
Ask the person to try walking a few steps on their heels, and then a few steps on their tiptoes.
If the nerve is significantly compressed, they might experience weakness. Difficulty lifting the front of
the foot while heel-walking (known as foot drop) points toward lower lumbar nerve compression.
The 90-Minute Sciatica Relief Protocol
Crucial Rule: Never press directly on the sciatic nerve or the spine. Focus your pressure on the surrounding
muscle bellies. If any movement triggers sharp, shooting, or electric pain down the leg, stop immediately.
Part 1: Warming & Lumbar Release (20 Minutes)
Position: Prone (Face Down)
Palpation & EFFLEURAGE (5 Mins): Warm up the lower back, glutes, and hamstrings
using broad, soothing strokes. Look for guarding (muscle twitching or tightness).
Lumbar Paraspinal Release (15 Mins): Use the thumbs or a reinforced palm to apply slow,
downward and outward pressure along the muscles parallel to the spine (paraspinals).
Focus heavily on the Quadratus Lumborum (QL)—the muscle between the lowest rib and
the hip crest. Releasing the QL helps take the pressure off the lumbar discs where sciatic
nerve roots emerge.
Part 2: Gluteal & Piriformis Deep Tissue Work (30 Minutes)
Position: Prone (Face Down)
Gluteus Medius & Maximus Release (15 Mins): Use your forearm or elbow to apply slow,
melting pressure into the glutes. Move from the sacrum outward toward the hip joint.
Targeted Piriformis Decompression (15 Mins): Locate the piriformis by finding the
midpoint between the sacrum and the outer hip bone. Use a soft elbow or thumb to apply
static compression (ischemic compression) on trigger points. Hold for 20–30 seconds while
asking the client to breathe deeply, letting the muscle melt under your pressure.
Part 3: Lower Trigger Point & Pathway Clearance (20 Minutes)
Position: Prone, then turning to Supine (Face Up)
Hamstring & Calf Stripping (15 Mins - Prone): Use knuckles or a forearm to strip down
the biceps femoris (outer hamstring) and gastroc/soleus (calf muscles). Tight hamstrings
pull on the pelvis, worsening sciatic compression.
Hip Flexor / Psoas Release (5 Mins - Supine): Flip the client face up. Gently work the
anterior hip (psoas and rectus femoris). Tight hip flexors tilt the pelvis forward, pinching the
lower back.
Part 4: Passive Stretching & Nerve Mobilization (20 Minutes)
Position: Supine (Face Up)
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Passive Double Knee-to-Chest
3 Minutes
Gently bring both knees toward the chest to open up the lumbar joints and create space in the lower
back. Hold for 30 seconds, repeat 3 times.
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Supine Piriformis Stretch (Figure-4)
7 Minutes
Cross the ankle of the painful leg over the opposite knee. Grasp the uninjured thigh and pull it gently
toward the chest until a deep, comfortable stretch is felt in the outer glute. Hold for 45 seconds.
Repeat 3-4 times.
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Hamstring Lengthening with Traction
5 Minutes
Lift the leg straight up (keeping it within a pain-free range of motion). Use a gentle, steady pull
(traction) toward you to lengthen the hamstring without forcing the hip joint.
4
Sciatic Nerve Flossing
5 Minutes
Hold the client’s leg at a 90-degree angle at the hip and knee. Slowly extend the lower leg upward
while pointing the toes away from the shin (plantarflexion), then lower it while pulling the toes back
(dorsiflexion). This gently “slides” the nerve through the soft tissue tunnel, breaking up minor
adhesions.
Post-Session Notes & Care
Hydration: Instruct the client to drink plenty of water to help flush out metabolic waste released from
the deep gluteal work.
What to Expect: Mild soreness in the glutes is normal for 24–48 hours. However, the shooting,
radiating nerve pain should begin to centralize (move up out of the calf/hamstring and stick closer to
the lower back/glute), which is a clear sign of progress.