What is Sciatica?
Sciatica is the name given to pain, numbness or weakness in the areas that are supplied by the sciatic nerve. These areas include hip, buttock, thigh, calf and foot. The sciatic nerve is the longest nerve in the body and when compressed, irritated or inflamed can be debilitating.
When does it occur?
Sciatica is often brought on by restrictions within the spine affecting the sciatic nerve and causing referred pain. Restrictions in the pelvis could cause a tightening in the gluteal muscles putting pressure directly on the sciatic nerve.
Sciatica can also be caused by more serious issues which is why it is important to consult a physiotherapist if you notice any referred pain in the leg. It may not always be a biomechanical or disc related issue that causes sciatica which is why its important it is diagnosed correctly.
Sciatica is most commonly preceded by a few weeks of back pain before the leg pain becomes worse than the back pain. In severe cases, it can damage nerves and leg reflexes and cause muscle atrophy of the lower leg most noticeably in the calf.
Often people wait until the pain is unbearable to consult with a physiotherapist. It is important to consult a professional when the pain initially begins as sciatica can cause long-term damage which means longer treatment and longer recovery times.
Sciatica can have numerous sources thus there are a number of Physiotherapy treatments, none of which involve drugs or surgery. Techniques we use include manual therapies (MT) including muscle energy technique (MET), core rehabilitation (CR), dry needling, soft tissue techniques (STT), trigger point therapy (TPT) and home exercise regime (HEP).
Consult one of our Physiotherapists to review your complete medical history and perform a thorough physical examination to determine the cause of your sciatica.
The Piriformis Muscle
Do you have pain in your buttock? Low Back Pain? Your Piriformis muscle may be the culprit.
Your Piriformis muscle is a small, deep, buttock muscle. Many of us have a tight piriformis muscle which can cause pain issues in your gluteal/buttock region as it passes right over your sciatic nerve. When your piriformis becomes tight it can compress your sciatic nerve and start creating all kinds of issues. Many of us sit at computer desks for many hours on most days. This essentially means that you sit on your sciatic nerve, gluteal muscles and piriformis muscle every day. If your nerve is calm and not irritated, that feels ok but if it is stirred up from a tight piriformis muscle your gluteal and buttock region can become extremely painful.
Symptoms of piriformis muscle syndrome
If your piriformis is irritated you may feel pain in your buttock region, pain down your leg, numbness and tingling traveling into your leg and foot, pain on sitting, standing and squatting down.
Our therapists determine if your sciatic nerve pain is originating from your piriformis muscle or from your spine. If your piriformis muscle is the culprit, you will feel like your pain originates in your buttock regions, not your spine. Another distinction between the two origins of your pain is that with a tight piriformis muscle you usually won’t have muscle weakness in the affected lower limb side whereas you if your pain originates from your spine you may get symptoms down the affected limb side.
Some men have had a sciatic nerve irritation caused or aggravated by sitting on their wallet in their back pocket. “Note– Never sit on your wallet” Piriformis muscle pain doesn’t have to be isolated to the muscle itself. You can have SIJ (sacroiliac joint) pain and wider spread gluteal muscle pain too.
Piriformis Muscle Treatment
Your physiotherapist will first identify the cause of your pain and symptoms. This may include a biomechanical assessment of certain movements involving your lower limbs and pelvis. We will then target hands-on treatment to release your tight Piriformis muscle. We will also assess and treat any tightness or symptoms around your other gluteal muscles and lower back if they are contributing to your pain issues. Treatment techniques that may be helpful include IMS Dry needling and Shockwave Therapy.