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Resolving Sciatica

SciaticaSciatica is a common form of back pain. The classical definition of Sciatica refers to pain along the large sciatic nerve – which runs from the lower back and along the back of each leg.

The pain can vary in location; it may go down the buttocks, through the thigh, down the back of the leg, or right down to the foot and heel.

RED FLAGS: It is important to watch out for the following red flags…since all of these require immediate emergency medical care.

  • Severe muscular wasting and atrophy.
  • Recent onset of bowel or bladder incontinence.
  • Saddle anaesthesia where there is a loss of sensation in the area of the buttocks and perineum (the area between the anus and scrotum in males, and between the anus and vulva in females). This can be a symptom of Cauda Equina Syndrome – a neurosurgical emergency – caused by compression of the nerve roots below the level of the spinal cord, and sometimes as a result of a prolapsed disc.
  • Severe sciatica after a fall or other trauma, indicating a possible spinal fracture.

Causes of Sciatica

Sciatica can be caused by disc herniation, compression of the lumbar nerve roots, spinal stenosis, and/or entrapment of the sciatic nerve anywhere along its path from the lumbar spine down through the leg. See the following for more details about the different causes of sciatica:

  • Sciatica Caused by Disc Herniation.
  • Sciatica Caused by Foramina Compression.
  • Sciatica and Spinal Stenosis.
  • Sciatica and Soft-Tissue Compression Syndromes.

Click on each of the following tabs, whose content is obtained from the book – Release Your Pain – for more information about these causes of sciatica.


Disc HerniationSciatica Caused by Disc Herniation

Sciatica that is caused by disc herniation is typically precipitated by a lifting or twisting injury. This type of sciatica will often cause pain to shoot down the leg whenever the person coughs or sneezes.

Sciatica caused by disc herniation can be identified by:

  • Applying the Valsalva Maneuver in which you are asked to cough or bear down, as during a bowel movement. If you have a herniated or bulging disc, you will experience pain shooting down the leg.
  • Identifying changes in sensation at dermatome sites (areas of the body that are associated with the pairs of dorsal nerve roots from the spine) which are specific to the disc that is ruptured.
  • Noting changes in deep-tendon reflexes caused by disc herniation. By checking deep-tendon reflexes, the physician is able to obtain information about the integrity of both the peripheral and central nervous systems.

Typically, decreased tendon reflexes indicate that there is a problem with the peripheral nervous system, while increased reflexes indicate a problem with the central nervous system.

Fortunately, the majority of cases of sciatica that is caused by disc herniation do not require surgical intervention, and can be resolved by techniques such as Active Release Techniques (ART).

Copyright: Dr. Brian Abelson and Kamali Abelson. From the book – Release Your Pain.

Sciatica Caused by Foramina Compression

Foramina CompressionForamina compression occurs when the nerve roots in the lumbar spine get ‘hung-up’ or restricted within an area known as the vertebral foramina.

These foramina are passageways through the bones of the vertebrae, and through which the nerve roots pass from the spine into the rest of the body. The size of the foramina varies depending upon its location.

Nerve compression in this area can be caused by bone compression (due to arthritic changes), disc herniation, scar tissue, or excessive ligament development.

Conventional medical procedures for resolving this problem requires surgical intervention (foraminotomy) to remove the pressure on the nerve roots.

However, when restrictions are caused by soft-tissue obstructions, it is possible to address this problem with Active Release Techniques. These special procedures are taught in the ART Long Tract Nerve Course.

The nerve-gliding procedures use specific patient motions with hands-on procedures to free up the restrictions at the foramina. When sciatica and all its related symptoms are due to foraminal soft-tissue restrictions, patients will typically see some improvement after each treatment.

ART cannot remove degenerative causes of foraminal compression, but it can remove some of the mechanical stress on the spine and aid in improving spinal stability; this is often enough to reduce pain and improve overall function.

Copyright: Dr. Brian Abelson and Kamali Abelson. From the book – Release Your Pain.

Sciatica and Spinal Stenosis

Spinal stenosis occurs when the spinal canal narrows and compresses the spinal cord and the nerves that branch out from that spinal cord. It is often caused by factors such as: disc herniations, thickening of ligaments, trauma (motor vehicle accidents), and spinal tumors.

Spinal stenosis is characterized by one or more of the following symptoms:

  • Leg pain that worsens with walking and improves with bending forward or sitting. Typically this pain occurs on one side of the body, with the degree of pain being subject to the degree of impingement or restriction.
  • Muscle cramping in the legs. The cramping worsens when walking downhill and improves when leaning forward.

An MRI (Magnetic Resonance Imaging) is usually needed to determine if you have spinal stenosis. Normal x-rays are not sufficient for ruling out spinal stenosis.

Serious or severe cases of spinal stenosis do require surgical intervention, but mild to moderate cases respond very well to Active Release Techniques, exercise, and activity management.

ART cannot remove the cause of spinal stenosis, but it can remove much of the mechanical stress on the spine and aid in improving spinal stability – often enough to reduce pain and improve overall function.

Copyright: Dr. Brian Abelson and Kamali Abelson. From the book – Release Your Pain.

Compression SyndromesSciatica and Soft-Tissue Compression Syndromes

Sciatica is frequently caused by soft-tissue compression of the sciatic nerve somewhere along its length (peripheral nerve entrapment) such as in Piriformis Syndrome.

The piriformis muscle is an external rotator of the hip and leg, and helps to turn the foot and leg outward. This muscle often becomes tight and restricted when it is overworked, resulting in compression of the sciatic nerve.

The most common sciatic nerve entrapment sites include adhesion of the sciatic nerve:

  • At the long head of the biceps femoris.
  • Between the adductor magnus and hamstring muscles.
  • Between the sacral ligaments.
  • Between the structures of the external hip rotators.
  • At the superior gemellus muscle where the sciatic nerve 
passes over the muscle.
  • At the piriformis muscle where the sciatic nerve passes under 
or through the muscle.
Copyright: Dr. Brian Abelson and Kamali Abelson. From the book – Release Your Pain

Resolving Sciatica with ART

Dr. Abelson Presforming ART Treatment for SciaticaThe key to resolving Sciatica lies in releasing the soft-tissue restrictions at all possible nerve entrapment sites, along the entire length of the sciatic nerve.

Complete resolution of Sciatica cannot be achieved if the nerve remains trapped at any point along its length.

This is where Active Release Techniques – Long Nerve Tract procedures excel since they can be used to find each of these entrapment sites, and then, to release the nerve from those sites.

More Information about Sciatica

Dr. Abelson provides a broad range of information to his patients and the public. They range from published books (eBook and hard-copy), to blogs, YouTube Videos, websites, and articles. Click on the following tabs to access some of his more popular information resources.


Books for Resolving Sciatica


Dr. Abelson's Book-Release Your PainRelease Your Pain: 2nd Edition

Dr.Abelson’s international best-seller – Release Your Pain – provides a detailed description about the anatomy, kinetic chain, and causes of Sciatica. It discusses means for resolving this condition, and provides specially selected exercises to help you begin the process of resolution. Visit our website at to purchase your eBook or hard-Copy.



Dr. Abelson's Book- Shoulder to Hand

Release Your Kinetic Chain: Exercises for the Shoulder to Hand

The phased exercise routines in Exercises for the Shoulder to Hand are designed to build and strengthen the neuromuscular relationships in the structures from your hand to shoulders. These exercises are a critical component of any treatment plan for the resolution of Sciatica. Visit our website at to purchase your eBook or hard-Copy.





Dr. Abelson's Book- Jaw to ShoulderRelease Your Kinetic Chain: Exercises for the Jaw to Shoulder

The specially designed exercise routines in Exercises for the Jaw to Shoulder provide a unique set of exercises that can help you to resolve your Sciatica. These exercises include self-massage techniques, and exercises that work to strengthen and stretch the muscles of the jaw and neck’s kinetic chain.  Visit our website at to purchase your eBook or hard-copy.


Blogs about Sciatica

Click on the following blogs for more information about Sciatica.

Resolving Sciatica with Active Release Part – 1Sciatica Blog

Sciatica is a nerve compression syndrome that can be extremely painful and difficult to manage for both the patient and practitioner. Sciatic pain often affects the lower back, gluteal region, and various areas of the leg and foot. Often, the symptoms effect only on one side of the body.