By WIN Contributor: Jeff Dill, Physiotherapist

“My doctor said I had sciatica.”  “I get this shooting pain from my buttock down my leg.”  Sound familiar?  “Sciatica” or “deep gluteal syndrome” can be a debilitating condition which can create significant discomfort as well as numbness and weakness.  But what causes sciatica and how can it be treated?

The Sciatic Nerve

Deep gluteal syndrome is caused by irritation to, or entrapment of, the sciatic nerve.  This nerve arises from a combination of nerve roots from the lower part of the spine (L4-S3).  In most individuals the sciatic nerve travels under the piriformis muscle before leaving the pelvis area and entering the back of the thigh, although about 10% of individuals have anatomical variations. (1)

The sciatic nerve travels down the back of the thigh splitting about two thirds of the way down into 2 separate nerves:  the tibial and the common peroneal nerves.  These two nerves continue down the leg, splitting & giving off other branches all the way to the foot.  Thus, the sciatic nerve and its branches supply muscles and skin from the buttock all the way to the foot.

What causes Deep Gluteal Syndrome (aka. “Sciatica”)?

Put simply, deep gluteal syndrome is generally caused by consistent compression on, or entrapment of, the sciatic nerve.  Both of these scenarios can be caused by overly tight gluteal muscles (ie. piriformis, gemelli). (2)

How do you know if you may be experiencing deep gluteal syndrome?  Well… you’ll likely experience one or more of the typical nerve irritation signs & symptoms including (shooting) pain, weakness, numbness and/or tingling anywhere along the path of the nerve.

Tips for Overcoming Sciatica

A physiotherapist can assist you in overcoming sciatic nerve pain through a series of soft tissue techniques, acupuncture, modalities, nerve gliding techniques, and stretches.

Here are also some tips you can try at home to assist in getting some relief are:

–        Try to avoid sitting for extended periods of time:  if able, get up for short walk breaks (only a couple minutes) every 30 minutes, or so.

–        Use a cushion if sitting on a hard stool:  this will assist in reducing the compressive force on the sciatic nerve

–        Use cushions on low-sitting chairs (including in your car if it’s safe to do so):  this will assist in creating less tension on the nerve by putting your hips in a less flexed position

–        Try not to sit slouched with your legs straight out in front of you (ie. while watching television at night):  sitting in this position is essentially like pulling on a (irritated) rope from both ends!

–        Try to loosen up the muscles in your buttock by rolling a golf ball or lacrosse ball on your buttocks while sitting or leaning against the wall (if safe to do so/balance is okay):  find tight spots in the muscles and oscillate back and forth or hold it on the sensitive area for 20-30 seconds.  Stop doing this if you feel shooting pain or increasing numbness/tingling down your leg.

These are just a few tricks that can be tried.  If sciatic nerve pain is hampering your normal daily activities, visit with a WIN Physiotherapist and we would be happy to help you.

REFERENCES:

1)     Khan, Karim, & Brukner, Peter.  Clinical Sports Medicine. 4th ed., McGraw-Hill Medical, 2012.

2)     Kulcu DG, Naderi S (2008) Differential diagnosis of intraspinal and extraspinal non-discogenic sciatica. J Clin Neurosci 15(11):1246–52

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