When you have sciatica, your back and hip pain can feel like it’s shooting into your legs. It feels like it starts in your lower back or spine and ends somewhere around your knee or calf. But what if the source of your pain actually starts much higher up? In fact, the source of your sciatica may be hidden not in your back but in the muscles in front of it: Your glutes, hamstrings, and even piriformis. The piriformis is a tiny muscle that sits deep inside your glutes on either side of your pelvis.
Trigger points (or “knots”) in these muscles can refer to pain down both legs, mimicking sciatica. The good news is that with massage therapy and self-care practices such as trigger point massage for sciatica, you can ease the pain from these trigger points so they no longer disrupt your life.
What Are the Sciatica Trigger Points?
Sciatica is a pain pattern that radiates down your leg from your lower back and buttock muscles. While this pain pattern is common among people with degenerative disc disease (aka, “slipped discs”), it’s also caused by muscle imbalances and trigger points. There are several muscles that can become knotted and painful, including the piriformis, gluteus maximus, gluteus medius, hamstrings, and even the calves.
These are knots of muscle that form in the muscles of the lower back (like your gluteus maximus and hamstrings), in your hips, and even in your piriformis muscle deep inside your glutes. These knots form when you are overactive or in spasm and cause pain and discomfort. When you have sciatica, these trigger points can refer to pain down both legs. While those with sciatica usually assume the pain is coming from the lower back, it’s possible that the pain is actually coming from trigger points in your glutes, hamstrings, or piriformis.
It’s important to be able to recognize trigger points in your sciatica muscles because they are treatable. You can massage the knots out of these muscles, ease your pain and get back to living your life.
Treating and releasing these trigger points can ease sciatica by releasing pressure on the sciatic nerve, which travels through these muscles. A trigger point is “a localized contraction knot” in a muscle generally caused by repetitive movement, poor posture, or an injury. The contraction of the muscle actually creates tiny tears, scar tissue, and low blood flow in the area. These trigger points can refer pain to in other areas of the body where they’re not located, including your legs.
Self-Care for Sciatica Trigger Points
While massage is a great way to treat specific trigger points, there are some simple self-care practices that can prevent these trigger points from ever developing in the first place. Check-in with yourself regularly, and ask how your body is feeling and how you’re sitting and moving. This can help you prevent unnecessary pain and discomfort before it starts.
1. Keep your core strong - Your core refers to your abdominal muscles and pelvic floor. Your core is responsible for keeping your spine and pelvis stable. Weak core muscles can lead to poor posture and misalignment of your body. This misalignment can cause your other muscles to compensate and become overworked, which can lead to trigger points.
2. Sit up straight - While this may seem like a no-brainer, it’s important to sit up straight (without “scooping” your lower back) and align your spine. This can help keep your core muscles engaged, which can help prevent trigger points from forming in other muscles.
3. Stretch at least once a day - In addition to your core muscles, stretching your hamstrings, calves, and glutes can help keep them relaxed and free of trigger points.
4. Be mindful of overusing your “bad” side - If you’re right-handed, be mindful of how much you’re using your left hand. Likewise, if you’re left-handed, be mindful of how much you’re using your right hand. Over time, this can cause your muscles to become overworked and lead to trigger points.
5. Warm up before you exercise - Many people with low back pain, sciatica, and piriformis syndrome will have difficulty exercising. This is often because they have trouble with core activation and engaging the right muscles in their lower back to support their spine. One way to work on this is to warm up before you exercise, especially if you want to do lower-back-loaded exercises. While this will not treat the root cause of the problem, it can help with the symptoms that keep you from doing the things you want to do.
6. Eat mindfully - Trigger points can be painful, but they can also have a significant impact on your quality of life. This is especially true if you have a lot of them, or if they are in a tricky area such as your glutes. One thing you can do is make sure you are eating a balanced diet so that your body has all of the nutrients it needs to heal properly.
7. Keep good posture - This is important for people with and without back pain, but it may be particularly important for people who have a lot of trigger points in their glutes, hamstrings, and piriformis. These muscles are hard to control, and if you don’t have good control over them, you may be retriggering them by sitting, standing, and moving in ways that put excessive pressure on these muscles.
Why Are My Glutes, Hamstrings, and Piriformis So Important?
Your glutes, hamstrings, and piriformis are some of the largest and strongest muscles in your body. They support your entire body while standing, walking, running, and climbing stairs. They also help keep your hips, knees, and ankles stable. If these muscles become weakened or imbalanced, they can lead to misalignment in your hips, knees, and lower back, which can cause trigger points in these muscles. These trigger points can then refer to pain and discomfort in your lower back, glutes, hips, and even down your legs.
This pain can be mistaken for sciatica, which is why these muscles are so important: They’re often the root of sciatica-type pain.
Trigger points in your glutes, hamstrings, and piriformis muscle cause harm in two very important ways: By causing pain and by disrupting your ability to walk. If you have trigger points in your glutes, hamstrings, or piriformis muscles, you may be unable to walk easily and may also experience pain while walking. Trigger points also cause your muscles to shorten, which can cause you to have a hunched-over posture. This can exacerbate feelings of low back pain.
How to Find Your Sciatica Trigger Points?
First, note where your sciatica pain is felt. Is it in your lower back? Around your hips? Or in your calves and/or feet? If it’s lower back pain, your trigger points are probably in your glutes, hamstrings, and/or piriformis.
Next, take a few minutes to self-test your muscles. You can do this with a lacrosse ball, tennis ball, or even a rolling pin (gently!) on your glutes and hamstrings. Place the ball on your muscle, and gently apply pressure. If the pressure causes pain, it’s likely that you have trigger points in this muscle. If you want to get even more specific, try palpating (touching) your muscles. This can help you feel for knots or “kinks” in your muscles that are likely trigger points. Use a light touch, and know that feeling your muscles is not harmful or painful.
If you have a lot of low back pain, sciatica, and/or leg pain, it may be worth spending some time finding and treating your trigger points. Here are the best ways to do this:
1. Gluteal muscles - Lie on your back with your knees bent. This will allow you to feel your gluteal muscles. You may feel knots or tight areas in this area. If you find a tight area, try applying pressure to it. You can also try stretching your gluteal muscles.
2. Hamstring muscles - To feel your hamstrings, stand with one leg slightly bent and the other leg straight. You should feel taut bands along the back of your leg, just below your buttocks. These are your hamstrings. Apply pressure to these areas, and if you feel a tight spot, try stretching it out.
3. Piriformis muscle - The piriformis muscle is deep in your gluteal muscles. To feel it, lie on your back with your knees bent. Squeeze your buttocks together, and you should feel a muscle on either side of your pelvis. You can apply pressure to your piriformis to see if you find any trigger points.
How to Massage Your Sciatica Trigger Points?
Find your sciatica trigger points. Use the above self-tests to find where your pain is and what muscles are causing it. Take note of where your pain is felt. Now you can find your trigger points. Place your hands on your lower back and feel your glutes. You should feel your gluteus maximus on either side of your pelvis.
Once you’ve found the glutes, move your hands down until you feel a knot in the muscle. This is likely a trigger point. Once you’ve found a knot in your glute, move your hands to the inside of your leg until you feel another knot. This is likely a trigger point in your hamstrings. Now, move your hands back up to the top of your glute until you feel another knot in the muscle. This is likely a trigger point in your piriformis.
Massage the knots out - Once you’ve found these trigger points, massage them out. Use firm pressure and massage in circles. If the pain becomes too intense, ease off the pressure and massage the area less vigorously.
Hamstring Massage for Sciatica
A hamstring massage can help ease sciatica pain. To massage your hamstrings, lie on your back on a mat or soft surface. Bend one knee and bring your foot to the other knee. Rotate your knee and foot so they face each other. Then, place a softball or your fingers (gently!) on the back of your thigh. Massage the muscle.
You can massage the hamstrings on both legs, but if you have more sciatica on one leg than the other, it’s worth focusing your massage on the leg that has more pain. If you have a lot of trigger points in your hamstrings, you can use the tennis ball method described above to massage them out.
You can also use a foam roller to massage your hamstrings, although you may find the tennis ball massage more effective. You can also try stretching your hamstrings. If you have a lot of trigger points in your hamstrings and you try stretching them out, you increase the risk that they will retrigger. This is because you are pulling on them and putting pressure on them, which may cause them to over-contract and form new trigger points.
Gluteal Massage for Sciatica
Glute massage can also help ease sciatica pain. Lie on your back on a soft surface. Bend one knee, and bring your other foot to the knee. Place your hands on the top of your raised knee. Now, massage the top of your gluteal muscle. Alternatively, you can sit on a chair with your legs uncrossed and your feet firmly planted on the floor. Bend your knee and use your hand to massage the top of your gluteal muscle.
You can massage your gluteal muscles to help them relax and release any knots in the muscles. You can use a tennis ball or a massage ball to do this. To effectively massage your gluteal muscles, lie on your back with your knees bent, a tennis ball under one buttock, and a massage ball under the other. Use your hands to knead the muscles in your gluteal region, and when you find a tight or painful spot, apply pressure to it with the ball. You can also try stretching your gluteal muscles to release tightness and help ease your pain. If you have a lot of trigger points in your gluteal muscles, stretching may not be an effective therapy.
Piriformis Massage for Sciatica
You can massage your piriformis on either leg, but if you have more sciatica on one leg than the other, it’s worth focusing your massage on the leg that has more pain. To massage your piriformis, lie face up with your knee bent and your foot on the floor. Use your opposite hand to knead your piriformis, and when you find a tight spot, apply pressure to it.
You can also massage your piriformis muscle to ease sciatica pain. To do this, you can massage your piriformis with a tennis ball or lacrosse ball to ease pain in this muscle and help it release trigger points that feed sciatica pain. Start with a gentle massage, making sure to breathe and let the tension flow out of the tight muscles. Try to massage your piriformis every day. As with all muscle pain, the more you massage it, the easier it will be to treat and ease your pain.
Steps to Massaging Your Sciatica Trigger Points
Now that you know how to find your sciatica trigger points and how to massage them out, here are 6 steps you can follow to massage your sciatica trigger points daily. These steps can also be used if you have other types of muscle knots in your body, not just the ones that cause sciatica. Choose one muscle group per day. You can massage all the trigger points in that muscle group throughout the day, or you can pick one that really feels tight and focus on that one.
Here’s an easy guide with steps to treating your sciatica trigger points. This is a beginner’s approach to self-massage, and you should ease into it, as the pressure can cause more harm than good if you’re not careful. You can also try this at-home self-massage tutorial.
1. Find the trigger point. You can self-diagnose the source of your sciatica pain by where it’s centered in your body and which movements or activities make it worse.
2. Create space and ease tension. This can be done using a tennis ball or lacrosse ball and applying a little bit of pressure so the ball pushes into the muscle. Focus on letting the ball ease the tension in the muscle rather than creating more tension by pressing too hard. Keep the ball moving and rolling over the muscle for about 30 seconds to a minute. Repeat on both sides.
3. Work on your hips, too. Your hips are important for helping you walk, stand, sit and even breathe properly. And weak hips are one of the main causes of low back pain, especially among middle-aged adults. Poor hip mobility can cause sciatica because the sciatic nerve runs through the hips, and if the hips are tight, they can put pressure on and irritate the sciatic nerve.
Bottom Line
Sciatica is pain stemming from the sciatic nerve, which runs from your lower spine down your legs. It’s one of the most common causes of leg and lower back pain, typically affecting people in middle age and beyond. The most common cause of sciatica is a herniated disc in your lower lumbar spine that compresses the sciatic nerve.
The sciatica trigger points in these muscles are referred pain — pain that’s focused in the same place as the trigger point. You can ease muscle pain with self-care techniques such as meditation, gentle stretching, and self-massage. Start with gentle self-massage, focusing on your glutes, hamstrings, and piriformis.