Journal
Sciatica: should you book massage or physiotherapy?
5 minute read. Written by the team at Back in Health, Kelowna.
In short
If the pain runs below the knee, came on with lifting or bending, or changes with sitting and standing, start with physiotherapy so the source can be assessed and a movement plan built. If it sits mostly in the buttock and hip with tight, tender muscles, massage therapy is a reasonable first step. Many people end up using both. Numbness in the groin or loss of bladder or bowel control needs urgent medical care, not either.
Two common sources
Sciatica describes a symptom, pain along the path of the sciatic nerve, rather than one cause. Often it starts in the low back, where a disc or joint irritates a nerve root. Sometimes the nerve is irritated further down, where it passes near the deep hip muscles, which is often called piriformis syndrome.
The first kind usually needs graded movement and time; the second often responds well to hands-on release of the hip and glutes alongside stretching.
How each discipline helps
A physiotherapist assesses which structure is involved, then builds a plan of movement and loading that settles the nerve and restores function. A registered massage therapist eases the muscle guarding around the low back and hip, which often makes moving less painful. A manual osteopath works gently on the spine, pelvis and hips as a whole.
At Back in Health all three are under one roof at our Kirschner Road clinic, so the plan can be shared rather than started over.
When to see a doctor instead
Get urgent medical care for numbness around the groin or inner thighs, new loss of bladder or bowel control, or weakness in a leg that is getting worse. Book a doctor's assessment for sciatica that follows a fall or accident, comes with fever or weight loss, or is not improving at all after several weeks.
Key points
- Pain below the knee or linked to bending: start with physiotherapy
- Mostly buttock and hip tightness: massage is a good first step
- Many people do best with both, coordinated
- Groin numbness or bladder changes: urgent medical care
General information, not a diagnosis or a treatment plan. If something is getting worse, or you are unsure whether it is right for you, speak to a clinician.