There are a variety of different types of back pain, and every one of them can be incredibly debilitating. Luckily, many types respond very well to hands-on manual therapy techniques. In this post, we discuss a treatment technique that can be highly effective for sciatica.

If you are dealing with back pain and would like to know if we can help, call or text us at (512) 693-8849.

We make a ton of training videos for our staff as well as other PTs around the world. Occasionally we post them on our blog so those out there suffering needlessly can get an idea of our approach to hands-on physical therapy, and see how we help others to get back to living the active lifestyle they want and deserve.

Below is one such video showing an example of treatment techniques for sciatica back pain.

Positional Release Technique To Fix Sciatica

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Video Transcription

(please excuse grammatical errors and the conversational nature of the transcription):

“We have determined that the strain has spasm going on in the piriformis, hitting the sciatic nerve (this condition is known as sciatica), and it’s not affected  in any way by lumbar movements. I did a piriformis test so it  seems like that’s at least part of what we’re dealing with.

What we’re going to do rather is perform a Positional Release Technique for the piriformis.  One of the companies that made this famous may refer to this as “Jones Strain Counterstrain”.

First, ask the patient to just relax and follow instructions.  Find the tender spot by asking the patient to identify it. Then hold that spot throughout the technique while moving the patient’s leg into a position where hopefully the pain diminishes. The idea here is to put the patient in a position where the pain is nonexistent and the patient only feels the pressure of the thumb. Let the patient give way to the leg and establish a pain scale. From now on, the patient should just let the leg hang left. So I have my hand just above the patella on the inside using my forearm and torso to support and lower the leg.

Then we’re going to raise the leg up a little bit because I know we’re going to be bringing this down and I have to hold this for 90 seconds. I want to make sure I’m in a right position to move and fold the leg.

I am in a position over at the edge of the table to start with this technique. So, you get the leg off and let me know if it’s making an effect to the pain underneath. I’m going to bring it further up in the flexion of the hip.  Then, I’m going to start some hip rotation and bring the patient to more flexion.

Now, recheck with the patient on the pain scale. If the patient says it feels better, you proceed to moving the leg while just trying to find a point in which it feels least painful; preferably no pain all.  When we get to that point, we have to hold it for 90 seconds and it puts the muscle into a relaxed shorten position.

I’m not sure how physiologically this works but with certain patients and certain situations like this, I’ve seen it make a huge difference right away in any kind of spasming muscle.

Once you reach this point, you just let the patient or have cue in them, make sure there is no tension building up under your arm or under your hands or anything and letting them know to relax by giving you the dead weight of their leg.

The way you support their leg is very important in this situation because if you don’t give them the feeling that you’re completely supporting the leg really comfortably then you’re not going to be able to let go of the leg and this technique will not work if these muscles are active in any way.

Going on, I’m going to bring the leg back up in super slow motion. As I do that, you need to think ahead in terms of where you’re taking the person’s limb, how you’re going to get there because as I move I’ve got to make sure that I’m moving very slowly for this technique to work.

Remember that the movement back to the starting position has to be super slow motion. You can’t move them quickly because the technique won’t work as well.

So I’m going to get my hand reset here and giving nice support against my belly as well. While the patient is relaxed, I’m holding the leg against my belly to give extra support, and she can fully relax.

So in the situation that the patient is not able to let her leg hang fully relaxed, I have the patient activate the antagonist muscle to try to decrease the activity of the muscle I’m really trying to keep relaxed.

Then let the patient almost work lightly against you trying to lift the leg up. The patient should keep slight tension in that direction as you move her limb.

The patient continues pushing down, a little bit down towards the table. You have to do this in situations where people just can’t let go and fully relax, which is not uncommon especially if there’s pain in the area.

After completing the technique,  we get them up and retest and the tests or motions that were painful before.”