When sciatica pain gets the better of you and nothing you do seems to help, here are some self-treatment tips you can use to get pain relief. Look at other suggestions in my Checklist Part 3. (There is a list of 17 corrective actions and treatments in three parts.)

Self-treat your muscles with pressure and massage, ice or heat (ice for pain and muscle spasm 1-5 minutes, moist heat for achiness and stiffness 1-5 minutes. (See my post on Ice or Heat)

The treatment protocol I use in my Neuromuscular Therapy practice near Boston is the following:

Use some kind of massage, vibration, short application of ice or heat first.  This gets the blood flowing and starts the lymphatic system draining waste products from the fluids around the muscles.

Find a place where the muscle is tender and has a tight place or a knot. If you feel any referred symptoms (sensation other than where you are pressing), it indicates that you’ve found a Trigger Point, a more important place to treat than just a place of tension.

Apply pressure with your thumb (or fingers, elbow, knuckle, a ball or some kind of pressure tool like the Theracane shown above),  increasing the pressure until you increase the pain to a level 6 on a scale of 1 to 10. (Too much pain turns on your body’s alarm systems which is not helpful when you’re trying to get your muscles to relax. Too little tenderness under pressure indicates a less than optimal treatment depth.)

Hold the pressure where it hurts and count for 8 – 12 seconds. You should feel either that the muscle is softening under your pressure or the pain is subsiding, indicating that the contraction is releasing. If nothing happens, hold the pressure for up to 20 seconds. If you still feel no change, keep your thumb in the same place and let up pressure to allow the blood to get to the muscle for maybe 10 seconds, then press in again and hold until you feel a release. I suggest repeating this procedure up to three times. If you aren’t getting anywhere, go on to another place and come back to this stubborn spot.

Finish your self-treatment with more “flushing” using massage or ice or stretching.

What is better, ice or heat? That depends on your symptoms. Think of a swollen ankle. The injury has stimulated inflammation. The appropriate application is ice, not heat. Heat will increase the inflammation and swelling. So if you have pain or swelling use ice. Also use ice when you have muscle spasms. With both conditions you want to turn off the nervous system temporarily. Ice increases blood flow through the capillary beds under the skin, increasing the removal of waste products that cause pain.

Heat is used for achiness and stiffness to increase blood volume in the larger vessels, warm the muscle, and bring oxygen and nutrients. Lack of oxygen causes muscle pain, nutrients are necessary to heal the tissue.

The next post is on treating medical conditions.