Do you have Sciatica or Piriformis Syndrome?
How our clients describe sciatic nerve pain…and Piriformis pain:
- Electric, shock-like pain from the lower back and into a leg and foot
- Stabbing, shooting or radiating pain into the legs
- Pins and needles sensation or tingling into legs
- Numbness or loss of feeling, usually of a foot
- Burning pain in the calf
This similarity in symptoms occurs because the sciatic nerve cuts through the piriformis muscle as it traverses through the pelvis, and the symptoms are those of an irritated sciatic nerve. Sciatica is a term which describes the back-into-leg nerve pain, and is not itself a diagnosis. Good and timely recovery requires you to know the source of your sciatica.
Shooting or radiating Pain, the sensation of electrical jolts, numbness, tingling and sometimes weakness, any or all, are the classic symptoms experienced by people suffering from nerve pain; and such is the case with sciatica. These symptoms appear when the sciatic nerve is inflamed or compressed.
The most common cause of sciatica is a herniated disc in the low back. Studies show that disc disease causes as much as 85% of sciatica. Less common reasons for sciatica are:
- spinal stenosis,
- spondylolisthesis (misalignment of one vertebra with respect to an adjacent vertebra)
- muscle spasms/injury most notably involving the piriformis muscle, and
- most rarely, serious pathologies.
Of all these causes, the one which appears to cause the most confusion is piriformis syndrome. Most researchers indicate that the incidence of involvement of the piriformis is 5% or 6% of those with clients who present with sciatic symptoms.
To recover well from sciatica, it is important to know the cause of the pain. Lumbar disc disease and herniated discs are typically made worse with slump sitting and other activities which cause the low back to bend or flex. Depending upon hip and leg position Piriformis syndrome may also be aggravated by sitting positions.
During an assessment, it is very easy to assume issues with the piriformis muscle, because testing yields a strong pain response. Yet we know from studies that 85% of sciatica is caused by disc disease. Here’s the problem...focusing treatment on the piriformis risks misses the significance of disc involvement. If this is overlooked, it is easy to experience progression of sciatic symptoms, even to the point of increasing the nerve injury. It is important to know whether the piriformis muscle or the intervertebral disc is causing the sciatic symptoms.
At our clinic, once the cause is identified, the key objectives of treatment are:
- fastest healing, for which we recommend bioflex low intensity laser,
- restoration or protection of spinal, pelvic and hip alignment, and
- improving muscle strength and endurance to protect against future injury.
Our best recommendations for a comprehensive treatment plan for those with sciatica start with physiotherapy assessment, posture analysis and correction (if required), low intensity laser because it reduces pain and inflammation and speeds healing an average of 40%. We incorporate massage and acupuncture to assist with pain control and muscle relaxation, when it is beneficial. When you are ready, a conditioning program to ensure you are strong enough to resume work and recreational activities.