So you’re experiencing sciatic pain (butt’s on fire) that runs down your leg, making the simplest of tasks miserable. Could it be piriformis syndrome?
Before I describe what piriformis syndrome is, it is imperative you go to your doctor first. Why?
Some questions that must be answered:
- Location of pain
- Severity of discomfort
- When the pain began
- Range of motion limitations
If the pain is great enough, the doctor will use x-rays to rule out herniated disks (L4-S1) or arthritis of the sacroiliac joint.
Herniated disks are nothing to mess around with and your massage therapist definitely needs to know if this is your true condition before commencing with massage therapy.
If the doctor’s diagnosis is that of “unruly muscles” that are spasming, or hypertonic (tight), thus placing irritation on the sciatic nerve – that’s where we come in to help.
So now, on to why sciatic pain can be due to piriformis syndrome.
The piriformis muscle happens to reside in a place that gives it an unusual opportunity that no other muscle has. The chance to choke-hold the sciatic nerve.
Deep in our posterior pelvis (butt) a small hip extensor muscle named piriformis performs its duty.
It’s a short muscle that crosses transversely under your cheek so it can laterally rotate your hip as well as Abduct your leg.
What?
Just think of Chuck Norris side kicking a wood square into oblivion.
So with that in mind, how does it effect the sciatic?
The origin of the sciatic nerve roots is off the lower lumbars and sacrum.
This puts it smack dab between our butt cheeks. Thus being a pain in your butt (pun intended).
The nerve then runs all the way down from our butt, and continues all the way down the back of our lower leg.
That is why sciatic pain can travel so far from its impingement site. It is the largest nerve in the body!
Where the sciatic nerve passes anterior (under) the piriformis is where the squeeze can happen.
Piriformis syndrome is caused by a shortened and spasmatic piriformis that puts pressure on the sciatic nerve.
It’s like someone pulling a fist full of your hair. Not Cool!
Our job as therapists is to reverse that!
As a side note: About 3,000,000 people a year suffer from sciatica. And about 200,000 of those patients have the condition due to piriformis syndrome.
So that makes you special.
As a practitioner of sports massage, I love to help patients with this condition.
If you want to go the massage therapy route, you might keep this in mind:
- Treatment of this condition can be discomforting (the piriformis hates to be worked) and you will want to call me bad names (true story)
- It takes some time to re-educate the muscle spindles (reset button)
- Relief is usually immediate but requires a few return visits
In the video above I show how we approach this syndrome through deep tissue massage therapy.
Doug Holland, LMT
Shirley Mann
“Doug and Lori are friendly, very knowledgeable, and professional. Doug does deep tissue massage with reflexology which realigns the muscles and nerves to restore your body’s balance. Helped me with a Morton’s Neuroma in my foot and the painful hip sciatica from limping with the neuroma. Amazing therapeutic stuff he does! Thank you.”