Piriformis and the Back

[Paradise Regained]

Very informative article about a little known muscle.

http://www.bodybuildingforyou.com/articles-submit/jesse-cannone/piriformis-syndrome-sciatic-pain.htm

 

[stormgale89]

I would view the above link with caution for several reasons, including;

Sciatic pain or 'Sciatica' is not synonymous with piriformis syndrome as it suggests.

The site itself is clearly very commercially weighted.

Piriformis syndrome also known as 'true sciatica' or 'sciatica proper' is relatively uncommon and sciatic nerve pain is much more commonly caused by a problem in the lower lumbar spine. NB Some of these are given, but some are distinctly lacking. i.e. referred pain, facet joint irritation /lock, nerve root irritation in the absence or disk herniation or prolapse, the latter they also fail to mention.

Sciatica simply means pain of the sciatic nerve, which starts from a collection of nerve roots deep in the buttock, runs deep in the back of the thigh and starts to separate into other nerves just above the knee.

If the pain is in the front or down the outside of the thigh, then it's not sciatic pain. That said, then if it's in the back of the thigh and continues to the lower leg, ankle or foot, then it can still be called sciatica.

I'm not disregarding the diagnosis of piriformis syndrome, in fact I am a great supporter of it and should not be missed, but in my experience and from that of colleagues and literature, well it just doesn't seem to be that common.

To put things in perspective - over 90% of us have some form of disk injury before we die. The most common disk injuries are that of the two lowest lumbar disks. I would add that the general consensus seems to be that the facet joint irritation /lock in osteopathic terms is much more common. In chiropractic terms this may be regarded as a subluxation and in orthodox medical terms - 'simple' or mechanical back pain with/without referred pain.

In comparison - in only a third of us does the sciatic nerve trunk actually penetrate and go through the piriformis muscle, therefore sciatica due to piriformis syndrome can actually only occur in that third where that is the case.

Please don't take offence by this JB - I just saw the referenced site and the soap box came out. Well that and it's stuff I deal with pretty much every working day. It would be nice if all cases of sciatica were due to piriformis problems as it would certainly make my life easier.

And.

 

[Andrea H]

I welcome your considered opinion and I presented the link for examination because I was not familiar with it.

 

[Ida Cecilie]

I am now having to think about getting to the doctors due to a really bad back at the moment.

Its mainly in the buttock area, but it also can travel down the outside of my thigh almost to the knee when it is really bad (its mostly painfully all the time, except when helped along with painkillers).
I am going to try and impliment a couple of days good rest to see if that helps first, but I would like to know, does anyone have any advice on what I can do to try and relieve this at home?

I cannot use anti inflamatory tablets - although I can tolerate in short term bursts gel.

Any suggestions please? Thanks in advance.

PS -Love the signature about Karma running over your dogma! Will use that myself now lol

 

[peyton blair summers]

just a question... i thought that in the other two thirds, an overly tight piriformis could still cause sciatica because the sciatic nerve passes under the piriformis. isn't that why pregnant women can be prone to sciatica, because their laterally rotated legs cause the piriformis to shorten and press down on the sciatic nerve?

cheers

henry