Sciatica commonly describes the symptoms of pain that radiate along the sciatic nerve and tend to be felt in the buttocks and down the back of the leg and sometimes right to the foot.
Sciatica is a condition caused by compression of the spinal nerves in the lower back, from possible herniated disk at L4/L5 nerve roots or SI joint dysfunction affecting the S1 nerve root leading to irritation of the sciatic nerve.
The sciatica symptoms one feels such as nerve and muscle pain, numbness, tingling and/or weakness tend to be different depending on where the pressure on the sciatic nerve occurs, however the pain felt is usually much worse in the leg than the back pain.
However only a small percentage of those who suffer from sciatic pain actually have structural issues leading to nerve compression in the lumber spine.
If you are experiencing sciatic pain in the hip, buttock or hamstring then you are most likely suffering from Piriformis Syndrome.
Unlike structural issues such as with degenerative disc disease, spondylothesis and sacroiliac joint dysfunction, most sciatica pain is a result of the sciatic nerve becoming compressed between the piriformis muscle and either the sacrospinous ligament and/or the bony sciatic notch in the buttock with what’s known as ‘functional entrapment syndrome.’
The piriformis muscle is a flat, band-like muscle located in the buttocks near the top of the hip joint. This muscle is important in lower body movement because it stabilizes the hip joint and is active in all lower body movements.
There are many tests that a professional manual therapist will perform to discern whether your sciatic pain is emanating from the lumber or sacroiliac region, or is the result of piriformis syndrome and will base their diagnosis through physical examination using a variety of movements activating the piriformis muscle and will ask questions about history of trauma to the area, repetitive, vigorous activity such as long-distance running, or prolonged sitting.
Because symptoms with piriformis syndrome can be similar to other more chronic conditions, it is common to undergo tests such as MRIs to rule out structural causes of sciatic nerve compression.
Unfortunately almost 70% of people who seek treatment for ‘Sciatica’ are wrongly diagnosed and often treated with surgical intervention. However researches in Los Angeles have developed a new nerve-imaging technology called Magnetic Resonance Neurography which has proven extremely effective in detecting piriformis syndrome and I would suggest this before considering surgery if an MRI scan proves inconclusive.
A highly trained remedial massage therapist will have a great deal of technical ability when treating piriformis syndrome and easing sciatic pain, including deep tissue massage or Trigger Point Therapy, heat therapy, assisted stretching and mobilization techniques to enhance healing by increasing blood flow to the area, decreasing muscle spasm.
Almost every treatment approach for piriformis syndrome will include a focus on carefully and progressively stretching the piriformis, hamstrings and hip extensors and your therapist may even a customized program of stretching and range of motion exercises for you to apply at home.
Here are a few things you may want to try for yourself before you seek out your local remedial massage therapist, osteopath or physiotherapist.
Two Simple Stretches for Piriformis Syndrome:
Known as the ‘Supine Pigeon pose’, first lie down comfortably on your back with knees bent and both feet flat on the floor.
Raise one leg (the affected leg) and rest the ankle of that leg over the knee of the opposite/supporting leg.
Reach over with both hands and grasp the knee of the supporting leg and slowly pull the thigh toward the chest and hold the stretch.
Hold for 30 seconds and repeat on the other side if necessary.
Best results if repeated morning and night.
Again lying on your back with both legs straight on the floor, take a towel at each end in both hands and hook it around your foot on one leg.
Pull your leg up and straighten by holding on to a towel tightly until a mild stretch along the back of the thigh is felt.
Avoid bouncing, as it can trigger a muscle spasm. Instead, enter the stretch gently and hold.
Start with holding the hamstring stretch for 10 seconds, and repeat a few times each day.
As you become more limber, gradually increase your hold to 30 seconds.
Repeat on the other side if necessary.
If you are still experiencing discomfort after giving these stretches a go for a few consecutive weeks, find your local remedial massage clinic like us here in Fairfield and book in a session.
Yours in Health,