You’ve been experiencing back pain for awhile but something has changed. You’re developing a dull achiness in the buttock and a shooting pain down the back of the leg. It’s worse when you stand up after you’ve been sitting for awhile and it flares up when you’re walking. Currently, the only thing that makes it feel better is lying down on your back. You mention it at work and a co-worker declares that you have sciatica and goes on to give you details of the debilitating pain and surgery that a family member with the condition had to endure.
A little online research can give you one explanation. Sciatica is an irritation of a particular nerve root as it exits the spine. It can be caused by herniated discs, narrowing of the canal that holds the spinal cord or degeneration of the vertebrae surrounding the area the nerve root exits the spine. You start worrying that surgery may be in your future.
There are other conditions that can cause sciatic-like symptoms and a few of them relate to the piriformis – a muscle that runs from your sacrum to the top of your leg bone. When it tightens excessively on one side, it can cause pressure on the sciatic nerve as it runs above, below or through the muscle. Tight muscles can develop adhesions and tight spots called ‘trigger points’ that refer pain from the tight spot to the surrounding area. The most common referral pattern of a trigger point in piriformis is down the back of the leg.
The condition is easily treated with massage and stretching. A therapist will loosen up the muscles of the low back and gluteal area, looking for especially sensitive tight spots that cause the referral pattern. The muscle is stretched and lengthened and tender spots may be held with sustained pressure until they release. The recommendation for homecare includes stretching the hip muscles and heating the surrounding area to prevent any recurring symptoms.