So, you go for a walk and your sciatic pain flares up. You sit for a long period and your sciatic pain flares up. You lay in bed a few minutes and your sciatic pain flares up. What gives? Chances are that your sciatic pain is caused by a deep hip rotator muscle called the piriformis.
The piriformis muscle is a pear-shaped muscle used in the external rotation of the hips. It is one of six deep muscles that aid in turning the hips outward, or laterally. Lying underneath the gluteus maximus muscle, it cannot be palpated without deep pressure from the hands. The location of the piriformis in the hip and its proximity to the sciatic nerve is what makes this muscle a source of what we call muscle-induced sciatic pain.
The external rotator muscles are constantly working for us. These muscles are used in activities such as walking, running, cycling, etc. We are using the external rotators all the time. Overuse, trauma, and lack of flexibility cause the piriformis to get tight. Positioned close to the sciatic nerve, a tight piriformis muscle can rub the sciatic nerve, causing irritation and compression similar to the feeling of a lumbar disc problem. It is this interaction of the piriformis muscle with the sciatic nerve that can cause sciatica. Tingling and numbness, sharp shooting pain down the back of the leg, weakness in the lower limbs are all products of this type of sciatica, also known as piriformis syndrome.
You can check the tightness in your piriformis and external rotator group muscles by finding a flat surface and lying down on your back. Look at your feet and see how far outwards your toes point. With the neutral position being toes pointing straight upwards, the average position of the feet should be approximately 30-40 degrees externally rotated. A larger angle could signify a tight piriformis muscle. Therefore, a treatment plan should be made to relieve the sciatica possibly caused by the piriformis. Natural treatment options for piriformis syndrome include massage therapy, acupuncture, stretching, and strength training.
The way I treat piriformis syndrome in my clinic is with a combination of acupuncture, massage therapy, stretching. I also like to send the patient home with the Sciaticare Ball along with a list of instructions on how to use the Ball for piriformis syndrome. Finally, a few stretches are given to the patient to help them get back on their feet quickly.
A typical piriformis treatment at the August Point Wellness Center would be:
- Acupuncture – Piriformis Motor Point (MP), Gluteus Medius MP, Gluteus Minimus MP, Tensor Fasciae Latae MP, Hua To Jia Ji L2-L5, GB30, GB21
- Massage – Quadratus Lumborum, Gluteus Muscle Group, External Rotator Muscle Group
- Stretching – Hip External Rotation, Hip Extension, Hip Flexion
- Sciaticare Ball – Recommend 1-2 times daily Sciaticare Ball treatment using: Piriformis, Gluteus Medius, Gluteus Minimus, & Tensor Fasciae Latae Techniques