Massage in Sciatica from 1886

From The Lancet, June 26 1886, p.1232

Professor Max Schüller of Berlin is convinced (Deutsche Med. Wochensch., No. 24) of the superiority of massage over other measures employed in the treatment of sciatica, and relates his experience of fifteen cases–all in males, and, except in one or two instances (which were traumatic), due to exposure to cold.  Most of the cases were dealt with from the first by massage ; but in a few instances electricity, vapour baths, &c., had been fruitlessly employed prior to coming under his care.  The modus operandi is as follows.  The patient lies on the unaffected side with knees and hips slightly flexed.  The course of the sciatic nerve is rubbed from below upwards, partly with both thumbs, partly with the ball of the little finger or thumb ; sometimes truck with the closed fist, sometime the musclular mass over the nerve pressed and kneaded with both hands.  The pain evoked by these manipulations soon passes away, and after a short time becomes less and less at each sitting.  The neuralgic pains very soon abate, diminishing after a severe and painful massage, then recurring with less severity, and gradually disappearing entirely.  The power of walking improves after each sitting.  On an average the treatments last about two weeks and a half, but in one case nine days, and in several from ten to fourteen days sufficed.  One patient abandoned the treatment after five days, owing to the pain caused by it, and tried without relief a fortnight’s course of electricity and vapour baths ; he then returned to the massage treatment, and was cured in two weeks and half.