Sciatica is a painful condition in which an impingement of the sciatic nerve causes pain to spread down to the limbs and feet. It can be caused by multiple conditions such as herniated discs, degenerative disc disease or acute injury. A lesser known cause of sciatic pain is the relationship between the piriformis muscle & sciatica.
What is the connection between the piriformis muscle & sciatica?
Buried under the gluteus muscles, there is a small muscle that connects the spine to the top of the femur. This is the main muscle that allows for outward movement in the hip. Also, the sciatic nerve passes directly underneath this muscle. And in some cases, can even pass through the muscles, which is called piriformis syndrome. When the piriformis impinges the sciatic nerve this it can create pain as well as decreased mobility and even issues with balance.
Issues with the piriformis muscle accounts for between 6-8% of severe low back pain or sciatica. These include:
Tightening or swelling of the piriformis in response to injury or spasm
Inflammation or irritation of the piriformis muscle
Irritation of the sacroiliac joint or hip
Sciatic nerve passes through the muscle and not below it (piriformis syndrome)
Issues with the piriformis muscle can be very painful and take awhile to heal. Making sure the spine is aligned to limit pulling on the area, stretching the piriformis to relieve muscle tension, and massage can all help relieve symptoms.
Stretching The Piriformis
It is first important to note that we recommend doing these stretches only in conjunction with the care of your doctor to avoid any further injury. Light, gentle stretching is the best approach as over stretching can also flare up symptoms. We recommend lightly warming the muscle before beginning. We recommend the following piriformis stretches:
Supine Piriformis Stretch: Lie on your back with your legs flat, pull the affected leg toward the chest holding the knee with the hand on the same side of the body and grabbing the ankle with the other hand. Pull the knee toward the opposite shoulder until the stretch is felt. Hold for 30 or so seconds then release.
Standing Piriformis Stretch: Stand with your back against the wall and your feet about 2 feet from the wall. Put your knees over your ankles and lower your hips 45 degrees to the floor. Lift the affected foot off the ground and place the outside of your ankle on the opposite knee. Lean your chest towards your knee while keeping your back straight. Stop when you feel the stretch in your glute and hold for 30 seconds then release slowly. This can also be done while sitting by placing the ankle across the opposite knee and leaning forward with a straight back.
Outer Hip Piriformis Stretch: Lie on your back and bend the knee of the leg with symptoms. Use the opposite hand to pull the knee over the opposite side. Keep your back flat. Stop when you feel the stretch in your hip and glutes. Hold for 30 seconds and release.
Groin Stretch (Long adductor muscles): Sitting on the floor with your legs out as far apart as you can. Tilt your upper body forward with your hands on the floor. Make sure you keep your spine straight and not rounded. If you can, drop to your elbows. Once you feel the pelvis stretching, hold for 30 seconds an release.
Inner Thigh Stretch (Short adductor muscles): This is commonly called the butterfly stretch. Sit on the floor with the soles of your feet together. Apply downward pressure to the knees with your elbows to increase the stretch. You can also bend your chest towards your feet with a straight back to increase the stretch. Hold for 30 seconds and releae.
Gluteal Stretch: For you yogis, this is called the pigeon stretch. From a plank or pushup position, pull the affected foot across and underneath the trunk of the body so that the affected knee is on the outside. Extend the other leg straight back and keep the pelvis as straight as possible while settling your weight back on your hips. Lean your torso toward the floor until a deep stretch is felt. The goal is to rest on your forearms but don’t overdue it. Hold for 30 seconds then release. Repeat this one a few times on each side.
Sciatic pain can be very painful, but it can be helped. Stretching and massage are some of the best ways to loosen the gluteus and pirifmormis muslces. And key to making these two things work, is having your spine aligned by a chiropractor. A misalignment can quickly pull the muscles and create even more pain and inflammation. Having everything aligned allows massage and stretching can begin to work on loosening these muscles.
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