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Sciatic pain? Stretch your butt!

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  • Sciatic pain? Stretch your butt!

    Here's the technical info...

    The patient with an unrelenting sciatica may be suffering with a piriformis syndrome. This syndrome is considered an entrapment neuropathy caused by pressure on the sciatic nerve by an enlarged or inflamed piriformis muscle. The sciatic nerve can be compressed between the swollen muscle fibers and the bony pelvis.1 Besides backache, the piriformis muscle contracture and associated adhesions has been related to radiating pain from the sacrum to the hip joint over the gluteal region to the posterior thigh, coccydynia,4 dyspareunia, male impotency5, and oblique axis rotation of the sacrum with its effect on the total spine up to the atlanto-occipital region.5

    According to Gray6 and Freiberg7 the piriformis arises from the anterior sacrum between the second to fourth anterior sacral foramina, from the margin of the greater sciatic foramen and from the anterior surface of the sacrotuberous ligament, the anterior sacrospinous ligament and the capsule of the sacroiliac joint. Freiberg states that the piriformis is the only muscle that bridges the sacroiliac joint. The piriformis passes through the greater sciatic foramen (the upper part of which it fills) and inserts by a rounded tendon into the upper border of the greater trochanter.

    Pecian8 examined 130 human specimens to determine the anatomical relations of the sciatic nerve and the piriformis. He found that in 6.15 percent of the cases the peroneal part of the sciatic nerve passes between the tendinous parts of the piriformis and a pinching of the nerve can occur. He found at least five other variations of the sciatic nerve in relation to the piriformis muscle. He concluded that when the nerve passed between the tendinous portion of the piriformis the nerve would more likely be pinched during passive medial rotation of the thigh which stretches the piriformis, causing the nerve to be pressed against the extended piriformis. In this case, resisted testing of the piriformis or ordinary active piriformis contraction would separate the tendinous portion of the piriformis surrounding the sciatic nerve and would not compress the nerve.

    Mizuguche9 felt that before the piriformis could aggravate the sciatic nerve there first had to be a preexisting tension on the sciatic nerve by scarring or arachnoiditis around the nerve roots secondary to laminectomy or some space-occupying lesion such as osteoarthritic spurs. He thought that ordinary walking would cause the piriformis to impinge the shortened nerve. A history of trauma to the sacroiliac or gluteal region has also been blamed10.


    Warren Hammer, M.S., D.C., D.A.B.C.O.
    References
    1. Jankiewicz JJ, Hennrikus WL, Houkom JA: "The appearance of the piriformis muscle syndrome in computed tomography and magnetic resonance imaging: a case report and review of the literature." Clin Orth & Rel Res:262,205-209.
    4. Thiele GH: "Tonic spasm of the levator ani, coccygeus and piriformis muscles." Trans Am Pract Soc 37:145-155, 1936.
    5. Retzlaff E, Berry AH, Haight AS et al. "The piriformis muscle syndrome." J AM Osteopath Assoc 73:799-807.
    6. Gray H: Anatomy of the Human Body. 26th ed. Philadelphia: Lea & Febiger, 1956:541.
    7. Freiberg AH: "Sciatic pain and its relief by operations on the muscle and fascia." Arch Surg 34:337m 1937.
    8. Pecian M: "Contribution to the etiological explanation of the piriformis syndrome." Acta Anat (Basel) 105:181-186, 1979.
    9. Mizughuchi T: "Division of the piriformis muscle in the treatment of sciatica." Arch Surg 111:719-722, 1976.
    10. Robinson D: "Piriformis syndrome in relation to sciatic pain." Am J Surg 73:356-358, 1947.
    11. Freiburg AH, Vinke TA: "Sciatica and the sacroiliac join." J Bone Joint Surg 16:126, 1934.
    "The problem is not that there are problems. The problem is expecting otherwise and thinking that having problems is a problem." -
    Theodore Rubin

    Mod @ Proactivehealthnet

  • #2
    While the article (I don't know that I left this in it) states that this is a very uncommon problem, I have struggled with severe sciatic pain for most of my life.

    Basically, the sciatic nerve runs through the piriformis muscle in your butt. If that muscle is tight it pinches the nerve causing pain that will radiate down the leg, across the lower back, through the perineal region. Fun.

    These are the stretches that have helped me live with it.

    Torture number 1:

    Sit properly in a chair or on a stool, straight up with your feet shoulder width apart and flat on the ground. Cross one leg over the other so that the outside of one ankle is resting on the top of the other leg's thigh, close to the knee. (Guy crossed leg). Depending on your flexibility press the crossed leg down until it's shin bone is parallel to the floor. If you can do this then lean forward (chest to leg) to stretch the crossed leg more. Hold this stretch for 30 seconds. Yeah! Now do the other leg!

    Torture number 2:

    Kneel in front of a bed (or what ever is at a height that you can lay your leg up on - I'll add a pic...you'll understand...I hope) bring one leg up so that it is laying on its outside on the bed in front of you much like the top leg's position in the previous stretch, only its on the bed instead of your other leg. Depending on your flexibility this may be all that you can do. Progress will be being able to lean forward or lay down on the lifted leg.

    Pics will follow shortly.
    "The problem is not that there are problems. The problem is expecting otherwise and thinking that having problems is a problem." -
    Theodore Rubin

    Mod @ Proactivehealthnet

    Comment


    • #3
      thanks, i also found that my wallet being in my back pocket caused alot of pressure and pain in my sciatic so i switched sides and it helped alot
      My style is impetuous, my defense is impregnable. I'm unna eat your style, i'm unna eat your style's kids.

      Comment


      • #4
        The pics of the stretches:
        Last edited by TheLil'Missus; 02-17-2005, 08:42 PM.
        "The problem is not that there are problems. The problem is expecting otherwise and thinking that having problems is a problem." -
        Theodore Rubin

        Mod @ Proactivehealthnet

        Comment


        • #5
          Originally posted by heavy hitter
          thanks, i also found that my wallet being in my back pocket caused alot of pressure and pain in my sciatic so i switched sides and it helped alot
          Dude, all you're gonna do is cause the problem on the other side. First off, thin the damn thing out. Get rid of all the receipts, you know you don't need them in there. Second, if your butt's in a chair, your wallet isn't in your pocket! You're messing up your spine with that 3 inch leather wallet.

          Or...

          You can just get another one, make it just as thick and put that one on the other side to balance things out.

          Besides, that'll be SHEXY!!! You'll definitely be attracting women that are into big...wallets!

          Hee hee.
          "The problem is not that there are problems. The problem is expecting otherwise and thinking that having problems is a problem." -
          Theodore Rubin

          Mod @ Proactivehealthnet

          Comment


          • #6
            ha ha thanks. i meant in the front pocket. sorry to be confusing. the sciatic pain was already there and i found that the wallet made it hurt worse. besides it's not that big,lol. thanks again for the pics. i tried out a few of them and i gotta say they are wicked painful, but i can tell they will work. thanks
            My style is impetuous, my defense is impregnable. I'm unna eat your style, i'm unna eat your style's kids.

            Comment


            • #7
              Originally posted by heavy hitter
              besides it's not that big,lol.
              You're talking about your wallet, right? :p

              Yeah, wicked painful is right! I love it!
              "The problem is not that there are problems. The problem is expecting otherwise and thinking that having problems is a problem." -
              Theodore Rubin

              Mod @ Proactivehealthnet

              Comment


              • #8
                i just did the first stretch, it actually feels good

                Comment


                • #9
                  Something else to keep in mind is you can do the seated stretch described above anywhere, anytime. TLM does it a lot sitting at the computer (post ho-ing here at IM).

                  Sitting, waiting at a doctors office.

                  Watching TV.

                  Watching your kids play sports (unless you are one of those parents that runs up and down the sidelines screaming like a lunatic--of course, this does count as cardio).

                  And for Richard85, sitting in the prinicipals office, waiting for an ass whuppin.
                  CrossFit Champions
                  Champions Combat Arts

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                  • #10
                    Originally posted by TheLil'Missus
                    You're talking about your wallet, right? :p

                    Yeah, wicked painful is right! I love it!
                    Yes, i was talking about the wallet, silly. but yeah the stertch is one of those pains that feels good at the same time. it feels like it is actually stretching the sciatic itself
                    My style is impetuous, my defense is impregnable. I'm unna eat your style, i'm unna eat your style's kids.

                    Comment


                    • #11
                      Originally posted by heavy hitter
                      Yes, i was talking about the wallet, silly. but yeah the stertch is one of those pains that feels good at the same time. it feels like it is actually stretching the sciatic itself
                      Me? Silly? Why I never!


                      Oh well...never mind. Yes, that's me. Dang it!

                      I just couldn't help myself! hehehehe!! :smooch:
                      "The problem is not that there are problems. The problem is expecting otherwise and thinking that having problems is a problem." -
                      Theodore Rubin

                      Mod @ Proactivehealthnet

                      Comment


                      • #12
                        That looks very interesting TLM, but I don't think I have that kind of flexability to do those stretches. But I will give them a shot tomorrow and see how I make out.
                        Official Web Designer of Intensemuscle.com :peace:

                        Advocate for Socially Relevant Search Engine -http://theenginuity.com

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                        • #13
                          just try the seated ones if you aren't too flexible. they work well
                          My style is impetuous, my defense is impregnable. I'm unna eat your style, i'm unna eat your style's kids.

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                          • #14
                            TLM....I suffered from severe sciatic pain during my last pregnancy. Wow, it was unreal! Nothing now though......pain free.

                            Comment


                            • #15
                              Originally posted by The Munster
                              Something else to keep in mind is you can do the seated stretch described above anywhere, anytime. TLM does it a lot sitting at the computer (post ho-ing here at IM).

                              Sitting, waiting at a doctors office.

                              Watching TV.

                              Watching your kids play sports (unless you are one of those parents that runs up and down the sidelines screaming like a lunatic--of course, this does count as cardio).

                              And for Richard85, sitting in the prinicipals office, waiting for an ass whuppin.
                              Im a sophmore in college man lol

                              Comment

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