Sciatica is often referred to as a condition. It is however, only a symptom. Pain, originating in the lower back and passing down the buttocks and in to the posterior leg, to be precise. The cause of this pain, as discussed many times before is compression (or impingement) of the sciatic nerve.
The most common belief as to the cause of this pain is disc herniation (a protruded or ‘slipped' disc). Visit most Doctors with sciatica symptoms and this will be the usual assumption.
However, in my experience, approaching half of cases involving sciatic pain, are actually muscular related. By far the most common of these is the Piriformis muscle. This is one of the small hip rotator muscles located deep in the buttock. This muscle is so commonly involved because of its close proximity to the sciatic nerve where it passes through the buttocks. In fact, in up to 20% of people, the nerve passes right through the muscle, as opposed to behind it. This leaves 20% of people are extremely likely to suffer sciatic pain, resulting from impingement of the nerve within Piriformis.
Treatment of sciatica caused by Piriformis impingement (often termed ‘piriformis syndome) usually consists of easing the tension within the muscle through massage and stretching, as well as finding the cause of the problem. One of the most common causes of increased tone within this muscle is weakness within the other gluteal muscles, noteably Gluteus Medius. Weakness in this muscle places extra load on the Piriformis when performing external hip rotation. If this is found to be the case, a simple side-lying clam exercise can be used to build Gluteus Medius strength.
Another muscular cause of sciatic-like symptoms, is referred myofascial pain from trigger points within the glutes. A trigger point is a tiny localized knot in the muscle. Pain may radiate through the buttocks and down the back of the leg, especially when pressure is applied. This is not true sciatica, as the sciatic nerve is not directly involved; however the symptoms are often very similar. Again, the treatment should incorporate massage therapy, stretching and strengthening of the gluteal muscles.
Muscular conditions should always be considered in the case of individuals presenting with sciatic symptoms, especially in the absense of back pain, a specific incident which triggered pain or people who have just taken up a new activity, such as running.
Heidi Mills BSc Hons GSR is a Sports Rehabilitator who graduated in 2005 from St Marys University, Twickenham. She runs a private injury clinic in Norwich, Norfolk and also works for The Virtual Sports Injury Clinic
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