Lower back pain is one of the most common reasons people come in for a session. But "lower back pain" is not one thing — it can come from very different sources and needs different approaches. Two of the most common types are lumbago and sciatica. They can feel similar at first, but understanding the difference matters for effective recovery.
Lumbago: The Sudden Lock-Up
Lumbago is acute lower back pain that usually comes on suddenly. You bend down to pick something up, twist the wrong way, or simply move too quickly — and your lower back seizes. The pain is sharp and localized to the lower back. It does not travel down your legs.
What has happened is a sudden muscle spasm, often combined with irritation of the small facet joints in the lumbar spine. The muscles lock up as a protective response, which is why it feels like your back has completely frozen. Most episodes of lumbago resolve within a few days to a couple of weeks, but the underlying tension and stiffness often linger much longer.
Sciatica: The Radiating Line
Sciatica is different. The pain starts in the lower back or buttock, but it radiates — sometimes all the way down the back of the leg to the foot. People often describe tingling, numbness, or a burning sensation along this path. That is because the sciatic nerve, the longest nerve in your body, is being compressed or irritated somewhere along its route.
Common causes include a herniated disc pressing on the nerve root, or the piriformis muscle in the buttock clamping down on the nerve as it passes underneath. The two feel very different once you know what to look for: lumbago stays in the back, sciatica travels down the leg.
How Massage Supports Both
Both conditions benefit from massage, but the approach is different. For lumbago, the focus is on releasing the spasmed muscles and restoring mobility to the lumbar spine. Infrared pre-conditioning helps enormously here — warming the tissue before hands-on work allows for deeper, more effective release without excessive force.
For sciatica, the work is more targeted. If the piriformis is the culprit, specific deep pressure on that muscle can take the pressure off the nerve. If a disc issue is involved, the surrounding muscles still need to be addressed to reduce the overall compression on the spine. In both cases, clients often experience significant relief after just a few sessions.