Sciatica - A Pain in the Butt

“Piriformis syndrome” is caused by an entrapment (pinching) or irritation of the sciatic nerve as it exits the back of the pelvis, deep within the buttock region. The sciatic nerve usually exits the back of the pelvis immediately below a muscle, called the piriformis muscle. The piriformis muscle is located on both sides of your body, deep within the buttock area. In rare situations (11% of population), the nerve actually passes right through the piriformis muscle. For various reasons, the piriformis muscle can go into spasm and entrap or even pinch the sciatic nerve. This can result in pain along the back of the thigh and knee, with further pain and/or numbness extending as far down as the sole of the foot, called “sciatica”.

Piriformis syndrome can result in “sciatica”. These same sciatica symptoms feel very comparable to that of a herniated disk. A herniated disk usually pinches directly on one of the five nerves that eventually form the sciatic nerve. Because the resulting symptoms of both of these problems are very similar (pain, numbness and tingling below the knee and into the foot), it is not hard to misdiagnose what is actually going on if you don’t look for both potential causes.
Specific diagnostic tests performed by your chiropractor are what distinguish a herniated disk from piriformis syndrome. In simple terms, with piriformis syndrome your chiropractor will not find many positive test results that indicate that the lumbar spine is involved. More often, the acute pain or tenderness is localized to the buttock and hip, while the low back appears quite normal and often pain free.

Many weekend athletes and people who spend long hours sitting in cars or at work are prone to this syndrome. The athlete's cause is commonly due to improper stretching and warm-up exercises as well as overuse during activity. In this case it is most likely that the piriformis muscle is irritated and usually in spasm. For the patient who sits for extended periods of time, their primary cause is due to contracture or tightening of the piriformis muscle. In this case the piriformis muscle is shortened and does not allow for the smooth movement of the sciatic nerve during leg motion.

Any treatment plan must include stretching of the gluteal or buttock muscles as well as stretching of the piriformis muscles. Dr. Landrum can help you by instructing you on the proper stretches and the correct way to perform them. A series of spinal and hip joint adjustments may also be required to relieve your symptoms.

If you are currently diagnosed with a disk herniation but are wondering if the symptoms you are experiencing may at least be partially from piriformis syndrome, call my office for an appointment to have it checked thoroughly. It is always a good idea to rule out other possible causes of your sciatica before simply having surgery.

If you have any questions about your back pain give me an email at landrumdc@gmail.com or visit my website http://www.landrumdc.com/