Phone0790 999093 AddressBeActive Clinic, 28 Castle Street, Hertford, England

The following is an overview of a common condition that leads to inflammation of the sciatic nerve, or sciatica, along with some simple remedies to help alleviate the discomfort.

You’re getting a slow nagging pain from underneath the gluteals, interspersed by sharp shooting pains down one leg? You’ve noticed it more frequently recently, and it’s getting worse? It is certainly aggravated by periods of sitting? Friends and close advisors knowingly advise you it’s sciatica? All sound familiar?

Well you probably do have sciatica where this very large nerve feeding the lower limb becomes, compressed, irritated and inflamed; all leading to some quite uncomfortable symptoms described above. The bigger question is ‘what caused this’, because an accurate assessment of the cause will, perhaps unsurprisingly, determine the treatment, and therefore a more rapid easing of the problem.

Sciatica may commonly arise from compression or impingement in one of two areas, the spinal structures in the lumbar region, or a deep group of muscles under the gluteals which are identified by the Piriformis muscle. The group of 6 muscles lead to a range of movements, the main one being to turn the lower limb or femur outwards (- external rotation). They are collectively known as the piriformis group, because the sciatic nerve passes underneath the group and surfaces from under the piriformis muscle, or in some people, actually through the belly of the muscle. This naturally has consequences if the muscle should become tight and inflexible.

These consequences include the symptoms mentioned above and may arise from two quite opposite sets of circumstances – inactivity, or over-activity. Inactivity, such as prolonged periods of sitting; at office desks or driving a vehicle, coupled with a lack of movement to stretch the piriformis muscle group can lead to a tightening of the muscle group which in turn, compresses the sciatic nerve giving localised discomfort, and pain radiating down one leg. Over-activity may include long bouts of exercise working the same muscles, such as rowing or cycling, and if accompanied by a lack of stretching, may also lead not only to a strengthening of the muscles, but a tightening of them as well. In either instance, if left unresolved, the symptoms often get worse, spreading to other times of the day and night, and affecting sleep.

Accurate assessment of this condition will ensure treatment of the correct muscles to alleviate any pressure over the nerve and allow any inflammation to be resolved. An examination will usually include analysing posture, possible ergonomics in a working environment, or an evaluation of biomechanics of specific sporting actions. Treatment may include deep tissue techniques to release the piriformis group followed by demonstration of effective methods of keeping these muscles flexible. Plus of course, sound advice and recommendations on lifestyle to help prevent the problem recurring.

A ‘piriformis syndrome’ can be quite indiscriminate, potentially affecting men and women of all ages and varying levels of activity. Treatment and adhering to a flexibility programme will usually be successful in resolving the problem, and if the muscle length can be maintained by targeted and frequent stretching, it can be prevented from returning. Although techniques by a practitioner may be used to immediately reduce the loading over nerve, perseverance is required to allow time for inflammation of the nerve sheath to settle down.

Tim Paine

Director at BeActive Clinic

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