Is your sciatic pain coming from your bottom?
A 51 year old female presented to the clinic complaining of left sided buttock pain together with pain and pins & needles in the back of her left thigh.
Examination & x-ray revealed only very minor problems with her lower back.
However, on palpation and testing of the muscles of her left hip, it was found that she had a tight and tender Piriformis muscle. This muscle originates from the sacrum and attaches to the top of the back of the leg near the hip. The Sciatic Nerve (which is the largest nerve in the body), passes over, under or through the piriformis muscle.
A Piriformis syndrome can develop, when a tight piriformis muscle inflames the sciatic nerve, causing hip aching along with pins & needles down the back of the leg, in the sciatic distribution.
Since the piriformis is an external rotator of the hip, treatment commonly includes inward-rotation stretches for the piriformis muscle and strengthening of the internal rotator muscles.
Complete care encompasses corrections of biomechanical faults of the lumbar spine and pelvis, as well as predisposing factors such as an anatomically short leg and/or foot pronation.
Rehabilitation for Piriformis Syndrome includes stretching and passive mobilisation. Improving the flexibility of the short and tight piriformis muscle is necessary. Muscle imbalance inhibits normal joint function and limits functional range of motion.
The use of custom-made, stabilising orthotics and/or heel lifts frequently is a necessary part of a comprehensive piriformis rehabilitation program.
The patient started the stretching immediately and along with a short course of treatment made a full recovery.