Your “sciatica” may not be what you think it is.

Sciatica is a fairly common medical condition, characterized by pain down the back of one or both legs, often accompanied by numbness and tingling, perhaps even weakness of that leg. From the Physical Therapy perspective sciatica is more of a symptom than a diagnosis. We seek to identify the underlying cause that is leading to the irritation of the nerve.

Although there are multiple sources that cause sciatica, such as a herniated disc in the lumbar or sacral spine, I commonly find that the sciatica-like symptoms are actually coming from a restricted, or “tight,” piriformis muscle. We call this Piriformis Syndrome. This muscle is deep beneath the glutes, and lies directly atop the sciatic nerve as it passes through the pelvis into the buttock and the back of the hip. When this piriformis muscle gets restricted, it irritates the sciatic nerve and results in symptoms of “sciatica.”

So how do we fix a tight piriformis muscle, and thus relieve the sciatica-like symptoms? Physical therapists can provide manual releases through deep massage or trigger-point dry needling treatments, but it is vital to also include mobility and focused stretching techniques of the hip. We also emphasize strengthening with hip and core exercises to restore balance of muscular strength and flexibility, in order to prevent the problem from recurring. After all, the pesky piriformis restriction that started this whole mess was most likely due to some sort of muscular asymmetry or imbalance—excessive sitting, compensation in your gait pattern, hips that naturally rotate outward (duck walking), etc.

The bottom line is that you should not feel hopeless or doomed to a life of leg pain if you are diagnosed with sciatica. The solution may be simpler than you think! The important thing is to keep moving and get in touch with one of the therapists at our clinics so we can guide you back to those fun summer activities.