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Sciatic Pain

By Jesse Cannone CFT, CPRS, CSPN
Click here to lose the back pain

Sciatica and Piriformis Syndrome are 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). This is nothing more than semantics.

Did you go see your primary care physician and get diagnosis of Sciatica, only to be referred to an orthopedic specialist who gives you a diagnosis of Piriformis Syndrome? Have you then gone to see a Physical Therapist and the PT tells you a little heat, ultra sound, electrical stimulation, and some therapeutic exercises will have you as good as new?

If this is the path you have been down and you're tired of all the worthless treatments that just donít work, help is here.

First, let me tell you why todayís traditional treatment methods just flat out miss the boat. The medical community is so conditioned and focused on treating only the symptoms and trying to get in as many patients a day as possible, that many people are misdiagnosed and/or mistreated.

Sciatic pain is caused by pressure being placed on the sciatic nerve. There are primarily 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. Often, people who have this condition donít 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. This can be caused by an event like a car accident, or by months of uneven pressure due to muscle imbalances. It is also important to note that many people with herniated discs donít even experience pain or symptoms, and many donít 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. These are covered in our Lose the Back Pain Video, along with step-by-step instructions on what to do to eliminate your imbalances and pain. You can learn more by clicking here.

Sciatic pain comes about due to a traumatic event, muscle imbalances, or 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. In most cases, the 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. If your recovery ends before strength and flexibility return, you will never be 100% recovered 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 standpoint, 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 foot points outward). So over time that muscle gets tight from the positions you put yourself in, and it weakens from lack of use.

Let me give you some examples of what I mean.

  1. If you sit on the edge of your chair with your legs separated and your feet pointing outward, you are keeping your Piriformis muscle in a shortened position and thatís how it gets tight. With extended sitting in that position, it gets weak from lack of use. Hence, the imbalance.
  2. Another example is runners (and bikers). They actually work very hard, and they tend to get sciatica because they fail to keep a strength vs. stretch balance in their workouts. The resulting imbalance creates a greater pull toward external rotation. This results in a tight Piriformis and an irritated sciatic nerve--and that's the source of sometimes intense pain.

You may not be a runner or cyclist but Iíll bet you have muscle imbalances that are causing your sciatic pain!

To learn more about muscle imbalances and how they affect your body, please read our article ďAches, Pains, and Injuries,Ē which you can find here.

Recovery Tip: In severe cases, the sciatic pain can run from the top of the hip to the bottom of the foot. It is very important to recognize that changes and shifting of pain is often a sign of improvement.

As a way of gauging recovery, take note of how far down the leg the pain goes. If the pain goes to the foot one day and then makes it only to the calf the next, and seems to be retreating upward (to the knee and then only to the hamstring, etc.), that is a sign of improvement.

You should feel good about those noticeable improvements and this should give you encouragement to keep working toward a full remission of pain.

So how do you get rid of your pain? Will learning one new stretch be enough? It very well may be. But depending on the severity of your condition, you may need to change your activities of daily living to include new stretches and new exercises. You may need to include activities use the hip rotators, such as inline skating, basketball, tennis, or golf. You will probably also need to faithfully perform corrective exercises specific to your situation. Our video covers such exercises.

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.

Sciaitic pain is not caused by a lack of prescription medications, so donít think that taking some anti-inflammatories or muscle relaxants will fix it. It wonít!

Many people are able to eliminate sciatic pain within days, just by performing a few specific exercises and stretches (but not general exercise). Find out whatís causing your sciatic pain and learn exactly which exercises and stretches you should be doing by watching our Lose the Back Pain Video. Order your copy now!




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