Low Back Pain and Sciatica - Will Massage Help?

Massage is a very commonly associated treatment for those suffering with Low Back Pain or Sciatica. However, how much of a role does it play with regards to getting to the cause of the problem?

I have been a physiotherapist for over 13 years now, and although I started out using treatments such as electrotherapy, mobilisations & manipulation, my emphasis now is very hands off.

This is because the majority of low back pain and sciatica problems are caused by muscle imbalances along with how we carry out our day-to-day activities (which themselves can lead to muscle imbalances and vice versa).

Therefore, the aim of treatment should not be about applying electrical devices simply to reduce inflammation or pain messages to the brain (that's assuming these devices can achieve that anyway) or loosening up tight joints with mobilisations or manipulation, but rather addressing the cause of the problem which is resulting in the inflammation, pain and stiff joints in the first place. This is achieved by addressing any incorrect movement patterns which may have been adopted during day-to-day activities, along with an appropriate stretching and strengthening exercise programme.

What about massage?

If there are tight muscles or other soft tissues present, placing increased stresses across the low back and sciatic nerve, this will definitely be a potential cause of pain. Consequently, having a massage for those tight soft tissues will definitely help relieve the pain and tension present. However, if that is all that is done and the cause as to why these muscles and soft tissues are tight in the first place is not addressed, it is likely the pain will return sooner rather than later.

So am I suggesting that massage is not appropriate, as it does not address the cause of the problem?

Absolutely not. Massage, without doubt, can play an important role in the rehabilitation of low back pain & sciatica. It is probably the only 'hands on' treatment I use. The difference is, I use it in conjunction with an appropriate stretching and strengthening exercise programme, along with addressing any day-to-day activities or bad habits which may also be contributing to the pain. I would never use it on its own as a treatment technique.

Therefore, if you are suffering with low back pain or sciatica and considering having some massage as treatment, my advice would be go for it, as long as you do not use it in isolation. It is important you also aim to address any muscle imbalance which may be present. Unless you do this, it is likely any relief you get will only be temporary.

Finally, it is crucial I mention one last thing. I would never carry out massage on someone who was in the acute inflammatory stage of low back pain or sciatica, where even the slightest of movements hurt and the subsequent increase in pain hangs around for some time. (I often use the analogy here of if you were to hit your thumb with a hammer and how sensitive your thumb would be afterwards!) If you were to have someone massaging your back during this phase, the chances are the only thing which will be achieved is increased pain & inflammation.