Do You Have Sciatica Or Piriformis Syndrome?

By Dr. Bryen Brown

October 15, 2017

It starts as some back pain and pain going into the buttocks. Now it’s going down the legs and sometimes there is numbness or pin and needles feeling and at others it feeling like the legs want to go out. Next step is going on the internet and searching the symptoms.

“What is Sciatica?”

We see many people that come into the office complaining of sciatica. It’s a condition that involves pressure, inflammation, or damage to the sciatic nerve. The sciatic nerve is comprised of multiple nerves from the lumbar and sacral spinal segments that bind together to create the larger sciatic nerve. Other symptoms besides pain can include numbness, tingling, weakness, and/or burning.

These sensations travels down through the buttocks, down the back of the leg, and into the foot. Pressure or irritation to the sciatic nerve can happen in many different ways as described later. Sciatica is said to affect 1 out of every 10 people within the 25-45 age range.

How Can Vertebral Pressure Cause Sciatica?

Sciatica is a common condition due to the numerous structures that have the opportunity to irritate the nerve. Discounting an acute traumatic event, pressure on the sciatic nerve usually occurs because of misalignment of bony structures in the lower back and/or imbalance in the musculature in the pelvis/buttocks. The roots of the nerves branch out from the spinal cord on both sides of the lumbar spine through a hole called a foreman.

Traumatic events, bad posture and repetitive motions can cause vertebrae or pelvis to get misaligned and fixated in the abnormal position. When this occurs the foreman begins to close and allow for compression on the nerve root. The pain travels down the path of the nerve with symptoms being felt down into the buttocks and down the back of the legs. When evaluating the spine for sciatica, we access the lower vertebrae in lumbar spine typically the L4 and L5 segments, the pelvis, and sacrum to check for any misalignment or imbalance.

Once an imbalance is located, we determine the best way to correct the offset structure to its normal alignment to relieve the pressure from the nerve. Chiropractic adjustments are one of the most cost effective and natural treatments for sciatica. It involves no drugs or no surgery and (in most cases) pain can be relieved from days to a few weeks.

Sciatic Nerve pressure can also be caused from damaged vertebral discs.

Another way the sciatic nerve can be irritated from the spinal level is pressure from damaged discs. Vertebral discs are similar to a cushion between each bony vertebrae. They are shaped like kidney beans and made up of cartilage on the outside and gelatinous material on the inside. Vertebral disc are very important to the health of the spine by performing a number of different functions.

One, they are the ligaments that hold the individual vertebrae together and allow motion of the spine, allowing you the bend and twist.

Two, they act as shock absorbers for every traumatic blow your body takes from walking or running step by step, to the bumps you run over in your car, to the hit you have to endure from JJ Watt.

Third and most important, they pump nutrients into and through the spine while pumping waste material out of the spine keeping the bones healthy.

The disc can be damaged in three ways:

1.) vertebral misalignment causing abnormal stress and decreased motion,

2.) pressure changes during repetitive motions,

3.) acute trauma abruptly putting more pressure than the disc can handle at one time, such as a hit from JJ Watt.

Imagine a balloon being squeezed, the more you add abnormal pressure to it, the wider the balloon gets. The bulging of the balloon is similar to the bulging of a disc. The more the disc bulges or herniates the smaller the space within the foreman, causing irritation to the nerves that make up the sciatic nerve.

Is Piriformis Syndrome Causing My Sciatica?

There’s a condition called Piriformis Syndrome that can cause sciatica. Piriformis syndrome is when the deep gluteal muscle called the “piriformis” can spasm and tighten so much that it can cause compression to the sciatic nerve. In that case, doing some stretching and strengthening exercises will help reduce that nerve pressure, but bigger question, “what caused the Piriformis syndrome?”

A common cause of Piriformis syndrome is participating in activities that can cause an imbalance in the pelvis. When the pelvis is out of alignment the muscles and joints are forced to work at a different level causing one side to wear out before the other creating spasms and in some cases strain and swelling. Chiropractic adjustments to help align the pelvis would be necessary in this case to balance your pelvis, which balances the muscle use and prevent the spasms of the piriformis muscle from compressing the sciatic nerve.

Chiropractic and Sciatica

If someone does an internet search or go to doctor that is not a chiropractor or chiropractic in nature, complaining of sciatica, they will likely get a list treatments that involve taking a medication, getting a spinal injection or surgery, or a series of stretches. Chiropractors treat this condition often and with great results by using manual adjustments to remove the nerve interference as well as realign the imbalance in the spine and pelvis.

There are exercises that can be done to improve motion and flexibility in the muscle to reduce tension and spasm, but the chiropractic adjustment to the will allow for better joint motion and muscle tone. Chiropractic care is also known to be the most cost effective treatments for sciatica. (And who doesn’t enjoy a better bang for their buck.)

To find out if you have sciatica and if we can help you at my office, we will take a detailed history to find out more about you, perform a very thorough examination to locate what structure is responsible for creating the symptoms, and also take an x-ray (if necessary) to have a image of exactly what’s happening in the back.

Dr. Bryen Brown

About the author

Dr. Bryen Brown is married to Dawn and has one son. He grew up in Bogalusa, LA and received his Bachelor of Science Degree in Biology from Grambling State University in 2008. He then attended and graduated from Texas Chiropractic College in 2012. Click Here To Read Full Bio

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