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By Daren Overmiller
Pain in the lower back that radiates down the back of the leg is commonly called sciatica. The most common cause of sciatica is the irritation of nerves in or near the lumbar spine. However, occasionally, the nerve irritation is not in the spine, but further down towards the leg. One likely cause of sciatica, in these cases, is piriformis syndrome. While piriformis syndrome can be very painful, it is rarely dangerous or requires invasive treatment such as surgery. Most people with this condition can reduce the pain and manage the problem with simple methods, such as chiropractic care and/or physical therapy.
What causes piriformis syndrome?
The nerves leaving the spine in the lower lumbar region join to form the sciatic nerve. As the sciatic nerve leaves the pelvis to go down the back of the leg, it runs under, or in some cases, through the piriformis muscle. The piriformis muscle can spasm, which squeezes and irritates the sciatic nerve, leading to the symptoms of sciatica. This can be the result of a fall or other injury to the lower back and pelvis.
What does piriformis syndrome feel like?
Piriformis syndrome commonly presents as radiating pain in one leg but can affect both sides in some cases. This pain is similar to pain caused by a herniated disc and is often misdiagnosed as such. Numbness and weakness in the leg or foot are rare but tingling in the leg is occasionally present. Pain may be made worse with sitting and relieved with walking.
What treatments are available?
In some cases, piriformis syndrome will resolve on its own as the piriformis muscle relaxes and pressure is removed from the sciatic nerve. Anti-inflammatory medications are commonly used to treat the pain and inflammation. However, if these don’t help the condition, treatment by a chiropractor can help to restore proper alignment to the lower back and pelvis, which may be what caused the piriformis muscle to spasm in the first place. Therapy, particularly stretching exercises and massage, may be used to try and relieve the tension in the piriformis muscle and reduce the irritation on the sciatic nerve. If pain persists after trying these treatments, injections may be needed. A local anesthetic, anti-inflammatory medication or even Botox can be used to reduce pain and relax the piriformis muscle. Surgery may be considered but, only as a last resort for the most severe cases.
Most patients with piriformis syndrome will be given daily at-home exercises and stretches that will be performed for several weeks to prevent the piriformis muscle from going into spasm again. Regular chiropractic adjustments and massage may also be beneficial in preventing future episodes.
Dr. Daren Overmiller practices at Childress Specific Chiropractic, 210 Commerce St. To contact Childress Specific Chiropractic, call 940-937-6600.