Thai Massage for Sciatica

(Name and certain personal details have been changed to protect privacy)

I was leaning against the far wall of a hot and humid room in Chiang Mai, Thailand. The fan in the center of the room did little to cool the oppressive heat outside. I wasn’t worried about the heat. Instead, I was fully engrossed in neatly drawing stick figures on my weathered notepad.

In front of me, my Thai massage teacher, Jack, was working on a client, in his usual slow meditative dance. Sometimes, I would forget to draw that special move or technique because I would get so entranced with the expert fluidity of Jack’s movements.

In 2006, I was fortunate to spend three months in Thailand with the sole purpose of mastering the art of Thai massage.

“Sensing, sensing, feeling,” was the comment I heard the most from my other Thai massage teacher, Koji. “You can touch the inside of the body through the skin. Everything is connected.” Being a massage therapist before studying Thai massage, I knew what he meant. As touch therapists, we touch the emotional and the energetic body through the physical.

Traditional Thai massage is that unique tool that carries within it a rare quality of enabling the practitioner to touch through many layers.

Back in the United States, I continue my passion and practice in Newton Center, MA.

When Melanie came in for her appointment, I could tell she was a little skeptical. She’s tried a few other therapies for her back pain. None worked too well. This time, her pain stemmed from a pinched Sciatic Nerve in the lower back (a condition commonly referred to as Sciatica). Luckily for Mel, the impingement of the nerve came from muscle tension and not a bulging disc in the spine. Regardless of the cause, the pain was excruciating and severely limited Mel’s daily life.

After the description of Thai massage and the combination of therapies I was to apply, Mel looked at me in disbelief. “Whatever you do,” she asked cautiously, “It’s not going to make it worse, is it?” I ensured that it would only help.

We started at the feet. In Thai massage, the belief is that most problems in the body will also manifest in the feet, and can also be treated by improving circulation and energy flow in the appropriate points on the soles of the feet.

We proceeded to work on the outer sides of Mel’s legs and hips. I reasoned that tight hip flexors and abductors (especially the infamous IT band, or the Ilio-Tibial Band) would cause a downward pull on the lower back muscles. Such hip tension could predispose the back to overstrain and discomfort.

Mel’s stiff hip joints proved my theory. I focused on releasing, softening, lengthening, and mobilizing. Slowly, the hip tissues started to give way and melt. Thai massage offers an incredibly wide variety of yoga-like stretches and passive joint movements that focus on loosening up the hips.

It all dates back to the time of the Buddha some 2,500 ago. As an ancient healing system with its roots in yoga, Buddhist spiritual practices, and Traditional Chinese medicine, Thai massage combines elements from all three. It was developed and practiced by Dr. Jivaka Komaraphat, the Buddha’s doctor and contemporary.

In those days, Dr. Jivaka would attend to sick monks, working out tensions from their joints stiff from austere meditation practices. Most of the work the monks required would concentrate on their lower bodies and, especially, their hips. Dr. Jivaka, or the Father Doctor, as he is still affectionately referred to in Thailand, came from India and used his knowledge of yoga, herbs, and energetic pathways (meridians) to treat monks’ aches and pains.

My next step was to address Melanie’s back itself. By now, most pressure stemming from the hips had been alleviated, and the back muscles already began to release its protective shield.

Carefully, and acutely aware of all the sensations in her lower back, Mel turned over to the prone position, lying face down on her belly. I tested and warmed the tissue, gently at first, then with more depth to my touch, probing past the superficial layers and aiming for deep underlying connective tissue, the fascia.

Methodically, I applied consistent friction to break up any possible adhesions in the ligaments around the sacrum and the lower spine. I walked and pressed my thumbs through the energetic pathways criss-crossing and encasing the back, pausing a little longer in the areas of palpable tightness.

Rhythmically rocking and swaying into my technique, as is characteristic of Thai massage, I found myself going into a sort of meditative state, intensely aware of the client’s body before me. My vision played a welcomed trick: the energetic meridians I was touching suddenly filled with a live and vibrant current that I could see and feel. The energy buzzed under my fingers. I saw three-dimensionally. My intuition sharpened and I knew what to do, where to touch, how to breathe.

As a closing, I lengthened Mel’s neck and pressed on a few relaxation points in the scalp. Her breathing was soft and shallow. She was deeply relaxed. I placed my hands together in gratitude and silently said a short prayer to all the teachers I have had and to the countless practitioners who, through the centuries, carried the tradition and preserved the ancient healing art of Thai massage.

When our session ended, Mel stood up, still careful, trying to sense the effects. She took a few steps. Her face brightened. “I don’t feel any pain right now,” she exclaimed quietly, unsure if the relief was only temporary. I encouraged her to take it easy for the rest of the day, drink more water, and take a bath to assist in further relaxation.

“We have to be realistic; the pain pattern and the postural habits that caused the pain are still there.” These were my final words of the day to Mel. “It may take us a few sessions to eliminate it entirely. The truth is, most of our daily habits and body mechanics have to be reassessed if we want to live completely pain-free. Some habits might have to be re-patterned. This is a process.” I smiled. She agreed to make a follow-up appointment.

Luckily, Mel’s pain dissolved after the first treatment. In our next session, I emphasized the same feet-hips-back relaxation pattern to entice the nervous system to build the new ‘wiring’ of the healthy back.


Slava Kolpakov, LMT, is the founder of East West Massage Boston and East West Massage Cambridge.

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