SciatiCare
Hands-On Technology for Healing Spinal Disc
and Nerve-Impingement Conditions
by Michael Curnett
with Mary L. Karlton

Many clients present with nerve-impingement symptoms; they are very common, yet can be so complex and poorly understood that they are one of the most mismanaged of health issues. Anyone who works hands-on, recommends therapeutic exercise, or teaches movement or fitness needs a working knowledge of how to recognize nerve-impingement symptoms and avoid aggravating their hidden vulnerabilities, which are exceedingly prevalent and more delicate than they seem. But how many of us know how to recognize such symptoms, assess their hidden vulnerabilities, and safely negotiate the aggravation hazards involved in touching, moving and positioning clients with these conditions?

Humans are predisposed to spinal strain and injury, and subsequent development of disc and nerve-impingement conditions due to a combination of evolutionary spinal development and human bio-mechanics. We can assume from the time humans stood on two legs, this kind of injury has been common.

The Harvard Medical School report Back Pain and Sciatica, states, “In many backaches that cause significant disability, the pain or numbness radiates down the leg or into the foot, a condition known as sciatica. At some time, up to 40 percent of people experience sciatica, which occurs when the sciatic nerve is trapped or inflamed.”

This statistic is only for sciatica; it doesn't include the spectrum of other nerve-impingement conditions, such as carpal tunnel and thoracic outlet syndromes.

Prevention is difficult

Sciatica is the most-common form of referred nerve symptoms (meaning symptoms originate elsewhere from where they are felt), defined as pain and/or numbness occurring in the buttocks, legs and feet. Also common are brachial-nerve symptoms affecting the arms and hands; however, nerve-impingement symptoms can be referred to any part of the body.

Referred nerve symptoms can result from the gradual onset of spinal problems, an injury to the spine, and/or tissue trauma local to the symptoms. After onset, people with chronic nerve conditions may over time develop concentrations of nerve inflammation, muscle contraction and tissue congestion.

The human body is poorly equipped to provide us with adequate sensory information to prevent development of spinal disc and nerve-impingement/inflammation conditions, and, once injured, to prevent further injury and aggravation. Disc and nerve conditions can be difficult to heal because people tend to continually aggravate their injury in the course of daily activities—mostly without being able to sense it at the time. Later, after a lag-time of hours or even days, referred pain or numbness symptoms escalate. This makes it hard for people to track how and when they aggravate their condition—and makes prevention difficult.

Gradual onset of referred nerve symptoms can result from internal spinal disc damage that develops unnoticed over a person’s lifetime. Because discs have no internal nerves, we cannot feel protrusions developing until disc bulge or herniation becomes severe enough to cause impingement of the spinal nerve roots. However, people won’t feel the pain of impingement at the spine because the nerve roots are part of the central nervous system, which doesn’t have localized sensation. Because of this, the body is dependent on referred pain or numbness symptoms to alert us to impingement of the spinal nerves. Yet as I said above, there is a lag-time after impingement of the spinal nerve roots, as swelling of the nerve sheaths extends outward to the efferent nerves where it can be felt. People only become aware of a problem when referred symptoms appear in the arm or leg, and unfortunately tend to limit their awareness (and treatment) to those locations.

All this confuses professionals and laypersons alike about how and where nerve symptoms originate, how to prevent aggravating them, and how to successfully treat them. Because of the hidden vulnerabilities, well-meaning health-care providers run the risk of unknowingly aggravating these enigmatic conditions.

The most-common treatments used to address disc and nerve conditions are symptomatic treatment; spinal surgery; and decompressive therapies. In the sidebar article, "Common Methods Used to Treat Disc and Nerve Conditions," the drawbacks of symptomatic treatment and surgery are detailed. Decompressive therapy is a better option; however, many patients are not able to benefit from conventional decompressive therapy because the machines are not appropriate for their delicate condition and significant aggravation vulnerabilities. Also, patient training is not provided to help them retain the position of the retracted disc protrusions, and the benefits of treatment are too-often lost in the course of their daily activities.

Machines cannot begin to match the ability of a skillful manual therapist to provide a more gentle, safe and thorough decompression through careful hands-on preparation and monitoring.

The alternative: SciatiCare

In SciatiCare, the therapy is customized to the specific needs of the client. The client is first prepared to receive spinal decompression by hands-on techniques to desensitize pressure-sensitive tissues, and relieve pain and muscle contraction. (According to the International Massage Association, a professional liability insurance carrier, manual techniques to facilitate spinal decompression are within the scope-of-practice of soft-tissue practitioners because no devices are used.)

SciatiCare is a neuromuscular re-education modality: Through the practitioner’s touch and moving of the client, and the client’s position, sensory information is imparted to enable reclaiming of lost motor, sensory and physiological capacities.

The last half century has seen development of many neuromuscular re-education bodywork modalities, which utilize the learning capacity of the brain to restore and improve the body, and body-sensory information to restore and improve the brain. Neuromuscular re-education has influenced physical rehabilitation, athletics, performing arts, education and psychotherapy. Throughout our lifetimes, our health and continuing personal development is dependant on the brain’s capacity for neuromuscular updating to reclaim functional abilities lost through injury, and to learn new abilities. It can be said that this learning capacity of the mind and body is central to the survival and evolution of species.

Trauma can cause muscles and nerves to become contractile and “forget” to relax. This is called somatic dysfunction. Our brains are dependant on sensory contrast for awareness, and if muscles are contractile long enough, the brain eventually loses awareness of the contraction. In the same way, if nerve sheaths are swollen long enough (a period of weeks is usually sufficient), the brain forgets how to release the interstitial fluid swelling the sheaths that causes referred nerve pain.

Neuromuscular re-education can provide the brain with the sensory contrast necessary to remind the brain of lost physiological capacities to relieve involuntary muscle contraction, chronic nerve inflammation, and restore our innate capacity for spinal decompression.

SciatiCare features manual-therapy techniques and client recovery management training developed specifically to affect these neurological, physiological and structural benefits:

Talking to the body

The SciatiCare Therapeutic Program consists of two parts: session work and recovery management.

Session work is specialized manual therapy that is customized to each client’s specific needs through sensory dialogue. By reading and responding to the client’s nervous system, the practitioner is guided by the client’s body to avoid aggravation and successfully create the conditions for healing. SciatiCare practitioners are trained to perceive, cultivate, interpret and respond to this language of the nervous system.

Our bodies continually communicate vital information necessary for our survival and well-being, such as being hungry, tired and cold. We respond with food, rest and warmth, and are rewarded with comfort and pleasure.

We are all, to varying extents, able to “read” what people are feeling by their body language: facial expressions, tone of voice, posture and movement. With experience we can become better at perceiving peoples’ body language. By being interested observers, we can help cultivate people’s sensory dialogue with themselves by the quality of our attention, and by responding to their needs. It’s like any other relationship; if the nervous system knows we are listening and responding, the quantity and quality of communication improves.

The language of the nervous system boils down to only two directives: “yes” and “no." “Yes” is communicated by to us by pleasure, “no” is communicated by pain. Through the traumatic stress of pain and coping, people’s sensory dialogue with themselves can become obscured, weak, confused, hysterical or disassociated. They can lose their ability to determine their preferences. Pain causes sympathetic nervous activity (the “fight-or-flight” mode), and the body can become so conditioned to it that its vocabulary shrinks to constant, hysterical no, no, no’s.

New clients are sometimes so pressure-sensitive that any touch is painful. When I first begin working with people who have high levels of pain and aggravation vulnerability, their bodies are often so conditioned to expect pain and aggravation that they interpret any contact as an aggravation hazard and have exaggerated sympathetic-nervous reactions. In these cases, I gratify the client’s preferences in comfort and win the confidence of their nervous system by my choice of positions, movement and touch.

Through receiving hands-on work without aggravation, the client’s body soon realizes the sessions do not hurt and do indeed help. The range of “safe” body areas and modes of working thereby increases, and defensive reactions decrease. This is how we can disarm the body’s defensive conditioning. Sensory dialogue restores and enhances our innate capacities, and the brain can even learn to create new sensory capacities to adapt to the need to avoid aggravation.

There are three modes I promote through sensory dialogue:

Sensory dialogue is really a very high level form of biofeedback. It is a way to befriend your body. It has a profound calming and empowering effect on the nervous system, especially for those disassociated and/or hyper-sensitized by trauma.

Post-session work

Recovery management is client training that empowers them to prevent aggravation of their injury and retain the benefits of sessionwork. After recovery, management continues to prevent recurrences of disc and nerve conditions and other injuries.

Recovery management consists of a slideshow depicting the specific spinal and nervous anatomy involved, and a packet of information the client studies and continues to refer to in order to prevent aggravation of their injury, retain the benefits of session work, and develop lifetime injury-prevention skills.

In some areas of the country, laws may preclude massage therapists from advising clients on anything other than massage; however, without knowing the laws of individual states, concerns of this kind are usually a matter of semantics, and can be handily avoided by the choice of words that practitioners use. For example, we do not diagnose, treat or prescribe. However, we may assess, conduct session work and make recommendations.

An opportunity to help

Steve, a former high-tech worker, is an example of a SciatiCare success story. After years of worsening sciatica, Steve developed a severely painful sacroiliac condition characterized by deep muscular contraction and spasms that "crushed the nerves,” as he describes it. With nerve symptoms affecting much of his body, his condition became completely debilitating and he was forced to give up his career. His stomach muscles were so tightly contracted that eating was painful, which resulted in rapid weight loss. His doctors decided he would not benefit from surgery. After many years and thousands of dollars spent on an endless round of ineffective treatments and pain medication, he was in such excruciating pain that he went to the hospital daily for intravenous morphine drip.

Then he heard of SciatiCare. "Over a period of months, Michael [Curnett, the author] brought me back from a desperate situation," Steve says. "Without SciatiCare, I'd literally be dead. It’s helped me get my life back again."

There is a tremendous demand for enhanced therapy and lifetime prevention of disc and nerve conditions, and becoming proficient in SciatiCare truly is a tremendous opportunity for service, and for making a getting-their-life-back difference for people.

Michael Curnett’s professional background spans 25 years in Structural Integration, Ortho-Bionomy®, energy medicine, movement and somatic studies, and neuromuscular re-education modalities. He is also a Guild-Certified Feldenkrais Practitioner®. Curnett is based in the San Francisco Bay Area and maintains a private practice in Santa Cruz, California.