Before you go for your first therapy session, first seek the advice of someone knowledgeable in this, who can advice you as to where the damage has occurred. Sciatica occurs because of a disc that has protruded from it's position in the spinal column and is putting pressure on the nerve root in the lower back, which forms part of the sciatic nerve.
Because your lower back and buttocks are involved when the sciatic nerve is affected, the therapist may start massaging and applying light pressure on these areas. The therapist will adjust pressure depending on your sensitivity to his/her touch in that area. At times deep vibrations that penetrate deeper to bring relief are applied.
The Piriformis muscle is one of the small muscles deep in the buttocks that rotates the leg outwards. It runs from the base of the spine and attaches to the thigh bone (femur) roughly where the outside crease in your buttock is. The sciatic nerve runs very close to this muscle and sometimes even through it! If the muscle becomes tight it can put pressure on the sciatic nerve and cause pain which can radiate down the leg.
The therapist will also concentrate on the Piriformis muscles and will slowly start massaging along the sacrum edge. The sacrum is a large, triangular bone at the base of the spine and at the upper and back part of the pelvic cavity, where it is inserted look at this site like a wedge between the two hip bones. Its upper part connects with the last lumbar vertebra, and bottom part with the coccyx (tailbone).
The therapist will adjust pressure and change technique depending on the patient and how they adjust to the massage.
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