Client: Walker, hiker and office worker

Problem: The Client complained of pain radiating from the lower back and pins and needles down the right side of the buttocks into the knee.  The pain varied from a mild ache to excruciating discomfort. Driving and sitting at a desk for long hours aggravated this and walking in the hills became more difficult due to pain in the buttocks and lower back. Eventually she reduced the hill walking to low level and then this became too painful.

Assessment: On examination of the lower back and buttocks area the buttock muscles were (hyper tonic) over tight/tense. On deeper palpation of the buttocks I found the Piriformis muscle inflamed which was pressing on the sciatic nerve.

Treatment: I applied deep tissue massage to relax the buttock muscles and pressure to the soft tissue on the piriformis muscle, which runs under the buttock muscles. This helps to relax the muscles, increases circulation, break up scar tissue and release the pressure on the nerve. I asked the client to regularly do buttock clenches between treatments to help relax the muscles.

Results: After the first treatment there was reduced pain and discomfort, which lasted for a few days. Between each treatment this improved, the buttocks began to relax and tone.  After five weekly treatments the pins and needles had completely gone and just a small ache after sitting for long hours.  They felt relieved and happy they could now enjoy the activity of hill walking again.