Evidence based

Sciatica Massage: Everything You Need to Know

Last updated: 
October 5, 2019
Kendray Rodriguez
Researcher and author
Dr. Juliana Bruner, DPT
Researcher and author, Physical Therapist

The sciatic nerve is the longest nerve in your body, starting in your lower back and extending all the way down to your feet. If your sciatic nerve roots become pinched or irritated, then you may experience significant sciatic nerve pain, which can make it difficult to sit, stand, walk, or even lie down.

Fortunately, 80-90% of sciatica cases resolve on their own or with conservative care (1). This can take several weeks however, so pain management is key until your sciatic nerve pain dies down on its own.

One good option for controlling sciatic pain is massage therapy. In this article, we’ll go over what causes sciatica and the benefits that massage therapy has to offer, the different types of massage therapy used in treating sciatic nerve pain, how to find a good massage therapist, and the risks associated with sciatica massages.

Sciatica Is a Symptom of a Larger Issue

Sciatica is a symptom, not a disease. Sciatic nerve pain can result from many conditions, including:

  • Lumbar spinal stenosis
  • Herniated disc
  • Pinched nerve
  • Spondylolisthesis (a condition where one vertebra slips forward over another)
  • Slipped disc
  • Degenerative disc disease
  • Piriformis syndrome (occurs when the piriformis muscle in your buttocks spasms)
  • Bone spurs
  • Muscle spasms

In rare cases, sciatica occurs when the sciatic nerve is compressed by a tumor or damaged by a disease like diabetes (2).

The classic symptom of sciatica is pain that radiates from your lower back down the back of the leg to your calf. It typically only affects one side of the body. Other symptoms you might experience are:

  • Low back pain
  • Numbness, tingling, burning, or weakness in your leg or foot
  • Pain in your hip or buttocks that gets worse when you sit down

You should seek medical attention right away if your sciatic nerve pain “follows a violent injury, such as a traffic accident” or is accompanied by difficulty controlling your bladder or bowels (3).

Summary

The burning, shooting pain associated with sciatica has a number of causes, including herniated spinal discs and spinal stenosis.

How Can Massage Therapy Help Sciatica Pain?

Sciatica massages serve to soothe tense muscles and release endorphins. In this section, we’ll discuss how both of these can relieve sciatic nerve pain.

  • Soothing tense muscles: Muscle tension in your lower back can put pressure on your sciatic nerve. Encouraging those muscles to relax through massage can reduce the pressure on your sciatic nerve.
  • Releasing endorphins: Endorphins are the “feel-good” chemicals released by your brain after going on a run, eating a good meal, and during sex. They’re also released during a massage and can provide temporary pain relief.

Scientific evidence supports the benefits of massage for sciatic nerve pain. Massage therapy has been shown to be effective for chronic pain relief associated with both degenerative disc disease and slipped discs, two causes of sciatica (4, 5). It’s also shown promise as a complement to physical therapy in the treatment of herniated discs, another common cause of sciatica (6). Studies have shown massage to even perform on par with NSAID medications in terms of pain relief in certain cases (7).

Summary

Sciatica massage provides pain relief by relaxing tense muscles and promoting the release of endorphins. A mounting body of scientific evidence supports the efficacy of massage therapy in the treatment of lower back pain.

Types of Massage Therapy Explained

While considered the hallmarks of luxurious spa days, massages aren’t just for relaxation. A medical massage – the use of various massage techniques as part of the treatment plan for a specific diagnosis – is a low-risk and effective way to manage sciatica pain (8).

In this section, we’ll cover a few types of massage therapy commonly used to treat sciatica.

Swedish Massage

Swedish massage is the most common type of massage. The primary focus of Swedish massage is relaxation, with practitioners using long gliding strokes and gentle or firm kneading to reduce tension (9). Studies have shown Swedish massage to be effective in relieving chronic low back pain (10).

Deep Tissue Massage

Deep tissue massage employs many of the same techniques as Swedish massage, but uses slower movements and stronger, more targeted pressure to relax, lengthen, and release tension in deeper layers of muscle and connective tissue (11). Research shows that deep tissue massages can result in significant improvements in chronic pain (7).

Myofascial Release

Myofascial release is a type of trigger point therapy that focuses on releasing restrictions in the connective tissue surrounding the muscles, known as fascia (12). Focused pressure and stretching are used to release the stiff, anchored areas in the myofascial tissue. Myofascial release and trigger points aren’t well understood, but studies have shown myofascial release therapy to be effective for relieving lower back pain (13).

Summary

There are several different types of massage therapy, and it can be a good idea to experiment with each to determine which will be most helpful for you.

How to Find a Good Massage Therapist

If you’ve decided sciatica massage is the right choice for you, your first step is to find a qualified massage therapist. You should thoroughly research the available options and make a careful evaluation in selecting your therapist. In this section, we’ll touch on some points to keep in mind as you conduct your search.

Get a Recommendation From Someone You Trust

One of the best ways to find a skilled massage therapist is to get a recommendation from someone you know. Talk to friends, family, and co-workers about the experiences they’ve had with massage therapists in your area. Ask questions to help you decide which practitioners would be good fits for you.

If you’re seeing your primary care physician for your sciatica, ask them for a referral to a provider who is skilled in sciatica massage techniques.

If all else fails, a quick Google search will provide you with a list of massage therapists in your area. Make sure to read their websites thoroughly – they should include information on educational qualifications and any specializations – and check reviews on Facebook, Google, and Yelp.

Find out What Your Insurance Covers

Insurance companies increasingly recognize massage therapy as an alternative treatment for pain relief. What that means is some insurance companies do cover massage therapy, some don’t, and some partially cover it. It’s important to know exactly what your plan will or will not cover before you make your first appointment, so read your plan documents thoroughly and call your insurance provider if you need clarification.

A prescription from your doctor can go a long way in getting your insurance provider to cover medical massage therapy. The Ohio State University’s Wexner Medical Center recommends asking your doctor to prescribe massage for the most general diagnosis possible, such as muscle pain, and to not specify the number and frequency of massages (14).

Check With Your Local Licensing Board

It’s crucial that the massage therapist you select is knowledgeable and takes their job seriously. Measures of a massage therapist’s credibility include the licenses they hold and their professional association memberships.

Massage therapy licensure is a tricky subject. In the United States, individual states oversee the licensure of massage therapists. Each state’s requirements are different, and some states (Kansas, Minnesota, Wyoming, and Vermont) don’t require massage therapists to have licenses at all. Some towns and cities in those states have their own municipal licensing programs, while others don’t (15).

If you live in an area where massage therapists are required to have a license, verify that your massage therapist’s license is active and that they don’t have any disciplinary actions on record.

Aside from state licensure, you’ll want to find out if your massage therapist holds any specialty certifications, a board certification from the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB), has received training at a nationally accredited school, or has memberships in any professional massage therapy associations (16).

Look for Someone Who Is Well-Versed in Multiple Massage Techniques

A massage therapist trained in more than one massage modality will be able to combine techniques to optimize the results of your massage. Try to find a massage therapist skilled in deep tissue massage and myofascial release therapy in addition to Swedish massage. You’ll ideally find a practitioner who has specific experience with treating sciatica.

Summary

A referral from a friend, family member, or your doctor is a great place to start your search for a massage therapist, but make sure you do your due diligence before making a final selection.

Reality Check: The Risks and Limitations of Sciatica Massage

Massage therapy is a non-invasive, low-risk treatment option for those suffering from sciatic nerve pain. Data shows a low rate of adverse effects associated with medical massage (17, 18). The biggest risk is a temporary increase in muscle soreness, especially after more intense massage modalities such as deep tissue massage.

While massage therapy is a safe treatment option for patients with sciatica, it’s important to remember that its sole purpose is pain relief. Massage won’t fix the underlying cause of your sciatic nerve pain. It can, however, improve your quality of life.

In spite of its relative safety, sciatica massage isn’t for everybody. If you have the following conditions, you should discuss alternative treatment options with your doctor:

  • Women in the first 12 weeks of pregnancy
  • Infections skin conditions such as boils, warts, cellulitis, impetigo, and scalded skin syndrome
  • Varicose veins, cuts, abrasions, bruising, or burns on the area to be massaged
  • Any contagious disease
  • Neuritis
  • Severe hemophilic disease

This isn’t an exhaustive list of contraindications for sciatica massage. As always, check with your doctor before beginning any new treatment regimen.

Summary

Massage is a safe, effective way to manage the pain associated with sciatica, but it won’t treat the underlying cause of your sciatic nerve pain. Talk to your doctor to see if you would be a good candidate for medical massage.

The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.

Research Citations

Researched, written, and reviewed by:
Kendray Rodriguez
Researcher and author
Kendray is a freelance writer with over eight years of experience. She holds a degree in English and Creative Writing from Hollins University. Kendray is also passionate about working on youth and community development, having previously served as camp director for the YMCA of Southern Maine.
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Dr. Juliana Bruner, DPT
Researcher and author, Physical Therapist
Dr. Bruner is a physical therapist who is highly trained and skilled in helping people overcome their physical ailments to live the best life they can. She is also a writer who enjoys spreading knowledge about various topics in the PT and healthcare industry.
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This article is based on scientific evidence, written by experts and fact checked by experts.

Our team of board-certified physical therapists, physicians, and surgeons strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.