Piriformis Syndrome and Sciatica

Sciatica and Piriformis Syndrome are essentially the same condition... it is just that the medical community is starting to call the condition by the muscle (Piriformis) that is involved and getting away from calling it by the name of the nerve that is involved (sciatic) nothing more than semantics.

Did you go see your primary care physician and get diagnosis of Sciatica only to have them refer you to an orthopedic specialist and than get a diagnosis of Piriformis Syndrome... and than be told to see a Physical Therapist and the PT tells you a little heat, ultra sound, electrical stimulation and some therapeutic exercises and we will have feeling like you used to?

If this is what you have experienced and you sick of all the ineffective treatments that just don’t work, you must read this article! It will be much different and far more effective than any article you have seen before.

Let's start out by talking about why most treatments fall short. The medical community is so conditioned and focused on treating just the symptoms and trying to fit in as many patients a day as possible, that many people are misdiagnosed and/or mistreated, and often neglected.

Sciatic pain is caused by too much pressure being placed on the sciatic nerve and there are usually four things that can create this... you may have one or more of the following:

1. Pressure caused by shortening and tightening of the piriformis muscle. This is almost always due to months or years of muscle imbalances in the hip rotator muscles.

2. Pressure caused by spinal stenosis, which is a decrease in the space between the vertebrae. This is primarily caused by uneven pressure and compression due to muscle imbalances.

3. Pressure caused by Isthmic spondylolisthesis which is simply when a vertebrae slips or moves... this can sometimes pinch the sciatic nerve but often times people who have this condition don’t have any pain, symptoms, or even know they have it!

4. Pressure caused by a herniated or bulging disc. A herniation is when a disc protrudes out from between the vertebrae and this can either be caused by an event like a car accident, or, by months or years of uneven pressure due to muscle imbalances. It is also important to note that many people with herniated discs don’t even experience pain or symptoms, and many don’t know they have the condition.

As you can see, there is a trend here... in nearly every case, muscle imbalances are the primary cause of the pressure being placed on the sciatic nerve.

If you are not sure which one of the four is causing your sciatic pain, I recommend you start with the basics. Most cases of sciatic pain are caused by muscle imbalances so if you begin to work on correcting any muscle imbalances you have, you should start to see improvement right away.

There are several self assessments you can perform to help identify which specific muscle imbalances you have and these are covered in our Lose the Back Pain System along with step-by-step instructions on what to do to eliminate sciatica pain

Sciatic pain comes about either due to a traumatic event, muscle imbalances, or a combination of both.

The event scenario is most likely the catalyst for sudden onset of sciatic pain. So what happens… when there is undue stress on the Piriformis muscle that stress causes it to go into spasm and then you have pain due to the Piriformis muscle putting pressure on the sciatic nerve.

In most cases, people go to physical therapy or minimize their physical activity to break the pain – spasm cycle and in most cases your symptoms subside. However…the event will also set you up for a lifetime of sciatic pain if the Piriformis muscle does not recover 100% in both strength and flexibility.

When you have an injury to a muscle, both strength and flexibility are compromised, and if your recovery ends before strength and flexibility return, you will never be 100% and will likely struggle with the problem forever.

The other way sciatic pain creeps into your life is due to your lifestyle and habits, and that is what we like to call the process. The process can be described as a prolonged onset of symptoms based on your everyday activities...

However, from a technical stand point the process really describes the development of the muscle imbalance in your hip. The Piriformis muscle is responsible for external rotation (moving your leg so your feet point outward). So over time that muscle gets tight from the positions you put yourself in and weakens from lack of use.

1 . If you sit on the edge of your chair with you legs separated and your feet pointing outward you are keeping your Piriformis muscle in a shortened position and that’s how it gets tight and with extended sitting in that position, it gets weak form lack of use. Hence the imbalance.

2. Another example is runners and bikers who actually work very hard tend to get sciatica because they fail to keep a strength vs. stretch balance in their workouts. Hence the imbalance creates a greater pull toward external rotation and the result is a tight Piriformis and an irritated sciatic nerve creating pain.

These are just two examples of how muscle imbalances can affect the Piriformis muscle and cause Sciatic pain. You may not be a runner or cyclist but I’ll bet you have muscle imbalances that are causing your sciatic pain!

So how do you get rid of your pain? Will learning one new stretch be enough? It very well may be. However depending on the severity of your condition you may need to change your activities of daily living to include new stretches, new exercises that include the use of the hip rotators like roller-blading, basketball, tennis, etc, and even better, specific corrective exercise specific to your situation... like those covered in our video. As always, learn as much as you can about your condition, so that you can ask the tough questions to your healthcare providers and get the best care possible.

Sciatic pain is not caused by a lack of prescription medications so don’t think that taking stron pain killers or muscle relaxants will fix it... it won’t! Also, many people are able to eliminate sciatic pain within days just by performing a few exercises and stretches... but not general exercise... the exact corrective exercises and stretches they need to do.