In every issue of our journal, you will find a Case of the Month, which we will select from among the submitted cases. Everyone who is using MEDICAL MASSAGE PROTOCOLS in their practice may submit their cases for review, and we will share with our readers the best one in every new issue.
Why do we think this case is so important? Let’s review the most common medical options available to a hypothetical patient with irritation or compression of the sciatic nerve. He or she will visit a family physician, who will prescribe pain medications, muscle relaxants, some stretches and rest. The majority of patients with Sciatica have learned from their own experience that such therapy, at best, brings just temporary relief.
The next option is physical therapy, and if only electrotherapy and exercises are used, it will take at least ten sessions to achieve pain relief. Frequently, this treatment doesn’t produce stable clinical results because it transfers the pathological condition into the latent or ‘sleeping’ stage, often with reactivations. Overall, exercising an already short and spastic muscle will never eliminate this abnormality completely.
In another scenario, the patient initially visits a chiropractor, who tries to manipulate their lower back and hip joint. Unfortunately, the majority of chiropractors don’t use massage therapy before manipulations, and this is why the chance of releasing the sciatic nerve from irritation by the piriformis muscle using manipulations alone is very slim. This is exactly what happened with the patient in the case presented below. Also, it takes a large number of sessions to release the nerve from pressure when manipulations alone are used or when massage therapy is used after manipulations.
In contrast, Diane Woodside showed that the application of the correctly designed MEDICAL MASSAGE PROTOCOL allows us to achieve stable clinical results quickly and efficiently. Let’s pause for a second and think about how much money her work saved the patient and the health system in general considering that it took her only two (!) sessions to free the sciatic nerve from the pressure and return her client to a normal life.
How many clients and patients like this one are wandering among different health practitioners without success and how much money their unsuccessful treatment will cost our health system? This is why we have published this case as a tribute to those massage practitioners who work in the shadow of traditional medicine, helping people who frequently give up hope of recovery and live with everyday pain, sometimes for years. Here is the case:
CASE OF FREEING THE SCIATIC NERVE FROM PRESSURE IN TWO SESSIONS OF MEDICAL MASSAGE
My client is a 73-year-old retiree. He worked as an air freight manager.
In 1997, he had spinal surgery at the L4-L5 level, and he was fine until two and a half years ago, when he started to feel pain in the right gluteal area. Later, this pain started to radiate down the right leg. When I saw him for the first time, the pain was radiating all the way down to the right foot.
He went to a chiropractor, who diagnosed his condition as Sciatica. Despite the chiropractor’s treatments and over-the-counter pain medications, he was still in severe pain. One of my clients referred him to me, and he decided to give massage a try.
Examination of the piriformis muscle showed intense spasm and irritation of the sciatic nerve there. He didn’t have any additional sensory abnormalities (tingling, numbness) besides the pain along the right lateral leg and right foot. He didn’t have any muscle weakness either. However, he had active trigger points in the gluteal and hamstring muscles.
I based my therapy on the MEDICAL MASSAGE PROTOCOL from Volume I of the Medical Massage textbook. I started treatment on his back to address the origin of innervation of the piriformis muscle. I used effleurage, circular friction along and across the lumbar erectors, kneading strokes and the Big Fold Technique along the paravertebral muscles.
For the next part, I worked in the gluteal area and used friction at the insertion of the gluteus maximus into the sacrum and circular friction around the greater trochanter. After that, I concentrated on the area of the right SI joint.
My next goal was to address the piriformis muscle itself. I used deep effleurage along the muscle fibers, kneading and light friction along and across the fibers of the piriformis muscle. All the techniques I applied were just below the patient’s current pain threshold.
I finished the session by working on his hamstring muscles and down his leg, using effleurage, kneading and circular friction along and across the affected muscles.
After about 4 days, he called to tell me that he was doing much better. The intensity of the pain had subsided dramatically. He wanted to schedule another session. The second treatment was the same as the first. After the second session, all pain was gone, and he hasn’t had a problem since January of 2008.
Such quick and efficient results greatly impressed my client, and I now see him regularly. I was able to fix his other problems as well. Periodically, I work on his piriformis muscle to keep it in check. Recently, his wife started to have similar symptoms in her leg, and he immediately brought her to me for therapy.
ABOUT THE AUTHOR
Diane Woodside
Diane Woodside graduated from Northwest Health Careers School in 1999 in Las Vegas, Nevada. She has worked as an independent contractor at Red Rock Country Club for 9 years and maintains a private practice.
Diane has studied many different massage modalities, but none has made a difference the way the science of massage has. Diane believes that the more she can learn, the better she will be able to help her clients. This is why she focused on studying and practicing medical massage.
Diane’s interests are oil painting, opera, classical music (Beethoven, Mozart) and reading.
She loves to travel, especially to Italy, where she has many friends.
Category: Case Studies
Tags: JMS 2010 Issue #3
