- The client is a 47-year old female with ongoing sciatic nerve pain on the left side.
- At the time of her initial appointment, she was going to the chiropractor for the pain and taking four ibuprofen to help her sleep through the night.
- She describes the pain as a burning sensation that radiates down the left leg.
- She feels that certain activities such as kickboxing class and sitting for long periods of time aggravate the pain.
- She also describes the pain as feeling “achey” in the morning when she first gets up.
- The initial range-of-motion assessment reveals greater restriction in the left hip, especially during external hip rotation.
- Tight bands are noted in the gluteal muscles as well, with the left side tension pattern more defined.
- QL and erector spinae group are very tight at the low back.
- Tight bands are also palpated in the rhomboids group on both sides of the spine.
- Anterior and middle scalenes are tight in the neck, with a slightly exaggerated forward head posturing noted.
- The client comes in for one 30-minute (Session 2) and four 60-minute treatment sessions.
- The first two sessions are spaced about 10 days apart, and the second and third session are spaced about two weeks apart.
- Sessions 3, 4, and 5 are spaced about 5 days apart.
- At the time of the second session, the low back, left side gluteal muscles and external hip rotators and left leg are the primary focus of the session.
- In all other sessions, the left external hip rotators are focused on heavily, while incorporating work on the back and neck.
- Chinese medical massage pressing, kneading, compression, and deep tissue techniques are applied to the back, neck, gluteal muscles, external hip rotators, and legs.
- The primary acupressure point worked for the sciatic nerve pain is GB30 on the left.
- Pressing and rotating into the left greater trochanter is also primary in each session.
- Gluteal muscles and external hip rotators on the left are frictioned, holding trigger points until release.
- Following the second session the client is able to exercise, including attend kickboxing class, without pain.
- She no longer needs to take pain medication at night in order to sleep.
- With the exception of sitting for long periods of time, the discomfort in her left piriformis remains minimal over the course of the next three sessions.
- With maintenance work, the sciatic nerve pain is limited to occasions when she engages in high impact activities, such as jumping jacks.