In the animation below you can see how close the sciatic nerve and the pirifomis muscle are in relation to each other. The piriformis muscle is in red and the yellow is the sciatic nerve. (You may need to refresh to see the animation)
Sciatica is often characterized by the following symptoms:
- Pain on one side of the buttock or in one leg that is worse when sitting.
- Burning, numbness, or tingling down the leg.
- Weakness, numbness or difficulty moving the leg or foot.
- A constant pain on one side of the rear.
- A sharp pain that may make it difficult to stand up or to walk.
We have a fairly large percentage of clients who come in for massage that have what is described is a burning pain, tingling, or numbness starting in their back, hips, and buttocks that will radiate down the back of the leg.
Piriformis syndrome, a very common condition seen by Massage Therapists, is six times more common in women than men. It can be one cause of (sciatic) low back, buttock or leg pain and can often be misdiagnosed as disc herniation or hamstring tendonitis which are also painful leg conditions.
Piriformis syndrome is a condition in which the piriformis muscle irritates the sciatic nerve. The sciatic nerve is the largest nerve in the body and at it’s largest point is about the width of ones thumb. The sciatic nerve’s origin is in the low back (lumbar region) and curves toward the middle of your buttock. It then extends down the middle of the leg, on the back side. The sciatic nerve usually passes underneath the piriformis muscle, however in approximately 15% of the population, it travels through the piriformis muscle, passes over the piriformis, or splits and passes around the piriformis. A problem arises when the piriformis muscle becomes tight or inflamed and compresses the sciatic nerve.
Unfortunately, the 15% of the population that has this problem are predisposed to have sciatic nerve pain. However, irritation and contraction of the piriformis muscle can also be a result of faulty footwear, poor posture or sitting habits, gait (posture when walking) disturbances, or turning of the foot.
The piriformis muscle can become shortened if the leg has been turned outward (externally rotated) for an extended period of time, such as when driving long distances, sitting at a desk, or by improper posture when running or walking. Once diagnosed by a medical professional, treatment of the shortened muscle can begin. Specific massage treatment for the piriformis muscle is often very effective. as stretching piriformis muscle can also reduce or control the aches and pains of a shortened muscle.
There are several ways to stretch the piriformis muscle. Here are a few simple ones you can do at home.
If you suffer from sciatic nerve pain, you should make it a habit to do these exercises. All stretches should be performed slowly, concentrating on the muscle being stretched. A stretch should feel like a stretch and should not ‘hurt’. Do not ‘bounce’ a stretch. A stretch should be held for a minimum of 20 seconds but preferably 30-60 seconds. Repeat stretch 3-5 times for the affected area, twice a day.
Massage is one of the recommended treatments for piriformis syndrome. A few thirty minute massages by one of us and routine stretching at home by you is the healthiest way to get your body back on track!