Most people who come in for low back pain aren’t sure exactly what’s causing it. Many assume right off the bat it is sciatica because of articles online. While they know something hurts in the same regions, it doesn’t mean every nerve related case is in fact sciatica. They know it’s been hurting for a while. But whether it’s a muscle problem, a nerve problem, or something else entirely – that part is usually unclear.
It matters, because the two pain patterns respond to treatments differently. Here’s a practical guide to reading your own symptoms.
What Muscle Pain Feels Like
Muscle pain in the lumbar region is usually described as a dull, heavy ache. It’s often dull – meaning it’s hard to point to one spot in particular.
It tends to get worse with movement and better with rest, at least starting out. It often feels like stiffness in the morning that loosens up as you move around. Pressing on the sore area usually produces a recognizable tenderness which may lead people away from massage to help.
Muscle pain is also often position-dependent. Bending forward makes it worse.
Certain movements reproduce it consistently.
It stays in the local area of the back rather than traveling down the leg.
What Nerve Pain Feels Like
Nerve pain has a distinctly different quality. People describe it as sharp, burning, shooting, or electric. It often travels – from the low back into the glute, down the back of the leg, sometimes all the way down and into the foot.
It can include numbness or tingling alongside the pain. It often flares in specific positions, particularly sitting for extended periods of time. It may even wake you up at night.
One hallmark of lumbar nerve pain is that the most bothersome symptoms may not be where the compression is. Your foot might feel numb because a nerve is being compressed at the lumbar spine – nowhere near your foot.
Why Most Low Back Pain Is Actually Both
Here’s the thing that makes this confusing: most chronic low back pain involves both patterns at once.
A compressed nerve irritates the surrounding muscles. Those muscles tighten to protect the area. That tightening increases pressure on the nerve. The two patterns feed each other in a loop that neither stretching nor medication fully interrupts on its own.
This is one reason people stay stuck in chronic low back pain cycles even after doing “everything right.” They’re treating one half of the pattern and wondering why the other half keeps coming back.
How Therapeutic Massage Addresses Both
Massage can’t unpinch a nerve directly. If a herniated disc is compressing a nerve root, that’s a structural problem requiring medical evaluation.
What massage does effectively is address the muscular component of that loop. When the muscles guarding around a compressed nerve release their chronic tension, the overall pressure in the area decreases. That reduction in mechanical load can meaningfully reduce nerve irritation – not by fixing the structural problem, but by removing one of the main things amplifying it.
For pure muscle-driven pain, the mechanism is more direct. Deep tissue work and ashiatsu both reach the lumbar paraspinals, quadratus lumborum, and surrounding hip musculature that drive most mechanical low back pain. Consistent sessions over time retrain those tissues out of their chronic guarding pattern.
When to See a Doctor First
Some symptoms need medical evaluation before massage is appropriate. If you’re experiencing any of the following, see a physician first:
Progressive leg weakness. Numbness or tingling in the inner thigh or groin. Loss of bowel or bladder control. Back pain following a significant fall or accident. Unrelenting pain that doesn’t change with any position.
These can indicate something beyond a muscle or nerve compression issue that needs to be ruled out. For the vast majority of people with chronic low back pain, though, those red flags aren’t present – and therapeutic massage is a safe, effective place to start.
If you’re not sure which pattern is driving your symptoms, the best thing you can do is describe them specifically when you book: where it starts, where it travels, what makes it better or worse, and how long it’s been going on. That information shapes the session more than any diagnosis label does. This is why so many people benefit the most from their bi-weekly scheduled sessions. Read more about it in our separate blog here.
Ready to get to the bottom of your low back pain? Book your appointment online or call/text 719-459-0780. Inspire Movements Massage Therapy is located at 1295 Kelly Johnson Blvd, Suite 250 in Briargate, Colorado Springs 80920. Open Monday, Tuesday, Friday, and Saturday 9am-7:30pm. By appointment only.