Sciatica

What is piriformis syndrome?

in Chiropractor by Doroski March 17, 2017 0 comments

At my chiropractic office in the Woodbridge, Dale City VA area sciatica is a very common complaint. There are numerous causes of the complaint and one of them is piriformis syndrome. That is the pain that starts in your buttock and shoots into the back of your leg. It has become a more common diagnosis but it is still overlooked. Here is some information on piriformis syndrome that may help.

Pain in the buttock that radiates down the leg is commonly called sciatica. The most common cause for sciatica is irritation of the spinal nerves in or near the lumbar spine. Sometimes the nerve irritation is not in the spine but further down the leg. One possible cause of sciatica is piriformis syndrome. Piriformis syndrome can be painful, but it is seldom dangerous and rarely leads to the need for surgery. Most people with this condition can reduce the pain and manage the problem with simple methods, such as physical therapy.

ANATOMY

What parts of the body are involved?

The lower lumbar spinal nerves leave the spine and join to form the sciatic nerve. The sciatic nerve leaves the pelvis through an opening called the sciatic notch.

The piriformis muscle begins inside the pelvis. It connects to the sacrum, the triangular shaped bone that sits between the pelvic bones at the base of the spine. The connection of the sacrum to the pelvis bones forms the sacroiliac joint. There is one sacroiliac joint on the left and one on the right of the low back. The other end of the piriformis muscle connects by a tendon to the greater trochanter, the bump of bone on the top side of your hip.

The piriformis muscle is one of the external rotators of the hip and leg. This means that as the muscle works, it helps to turn the foot and leg outward. Problems in the piriformis muscle can cause problems with the sciatic nerve. This is because the sciatic nerve runs under (and sometimes through) the piriformis muscle on its way out of the pelvis. The piriformis muscle can squeeze and irritate the sciatic nerve in this area, leading to the symptoms of sciatica.

CAUSES

What causes this problem?

The symptoms of sciatica come from irritation of the sciatic nerve. It’s still a mystery why the piriformis muscle sometimes starts to irritate the sciatic nerve. Many doctors think that the condition begins when the piriformis muscle goes into spasm and tightens against the sciatic nerve, squeezing the nerve against the bone of the pelvis.

In some cases, the muscle may be injured due to a fall onto the buttock. Bleeding in and around the piriformis muscle forms a hematoma. A hematoma describes the blood that has pooled in that area. The piriformis muscle begins to swell and put pressure on the sciatic nerve. Soon the hematoma dissolves, but the muscle goes into spasm.

The sciatic nerve stays irritated and continues to be a problem. Eventually the muscle heals, but some of the muscle fibers inside the piriformis muscle are replaced by scar tissue. Scar tissue is not nearly as flexible and elastic as normal muscle tissue. The piriformis muscle can tighten up and put constant pressure against the sciatic nerve.

SYMPTOMS

What does the condition feel like?

Piriformis syndrome commonly causes pain that radiates down the back of the leg. The pain may be felt only on one side, though it is sometimes felt on both sides. The pain can radiate down the leg all the way to the foot and may be confused for a herniated disc in the lumbar spine. Changes in sensation and weakness in the leg or foot are rare. Some people say they feel a sensation of vague tingling down the leg.

Sitting may be difficult. Usually people with piriformis syndrome do not like to sit. When they do sit down, they tend to sit with the sore side buttock tilted up rather than sitting flat in the chair.

+scottdoroski3122/posts

+doroskichiropractic3122/posts

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Piriformis syndrome

in Chiropractor by Doroski August 5, 2016 0 comments

For the patient back and leg pain is never something simple. It hurts and it goes into my butt and leg so this has to be a disc injury! Unfortunately, sometimes the problem is a disc injury and may require surgery. But more often than not it is something fixable without the need for surgery! There is a small muscle in your butt that can cause you big problems. Your Woodbridge, Dale City VA chiropractor wants to inform you about your piriformis muscle.

When the piriformis muscle shortens or spasms due to trauma or overuse, it can compress or strangle the sciatic nerve beneath the muscle. Generally, conditions of this type are referred to as nerve entrapment or as entrapment .

Inactive gluteal muscles also facilitate development of the syndrome. These are important in both hip extension and in aiding the piriformis in external rotation of the femur. A major cause for inactive gluteals is unwanted reciprocal inhibition from overactive hip flexors (psoas major, iliacus, and rectus femoris). This imbalance usually occurs where the hip flexors have been trained to be too short and tight, such as when someone sits with hips flexed, as in sitting all day at work. This deprives the gluteals of activation, and the synergists to the gluteals (hamstrings, adductor magnus, and piriformis) then have to perform extra roles they have not evolved to do. Resulting hypertrophy of the piriformis then produces the typical symptoms.

Overuse injury resulting in piriformis syndrome can result from activities performed in the sitting position that involves strenuous use of the legs as in rowing/sculling and bicycling.

Runners, bicyclists and other athletes engaging in forward-moving activities are particularly susceptible to developing piriformis syndrome if they do not engage in lateral stretching and strengthening exercises. When not balanced by lateral movement of the legs, repeated forward movements can lead to disproportionately weak hip abductors and tight adductors

Another cause for piriformis syndrome is stiffness, or hypomobility, of the sacroiliac joints. The resulting compensatory changes in gait would then result in shearing of one of the origins of the piriformis, and possibly some of the gluteal muscles as well, resulting not only in piriformis malfunction but in other low back pain syndromes as well.

Piriformis syndrome can also be caused by overpronation of the foot.[citation needed] When a foot overpronates it causes the knee to turn medially, causing the piriformis to activate to prevent over-rotating the knee. This causes the piriformis to become overused and therefore tight, eventually leading to piriformis syndrome.

Call your Woodbridge, Dale City Va chiropractor if you have similar complaints and get a proper evaluation.

+scottdoroski3122/posts

+doroskichiropractic3122/posts

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Leg pain and the piriformis muscle

in Chiropractor by Doroski January 15, 2016 0 comments

Low back pain and sciatica are very common reasons to see your Woodbridge, Dale City VA Chiropractor. We often diagnose patients with a small muscle in your buttock as being the cause of their big pain. The piriformis muscle can cause low back pain, buttock pain and sciatica. The piriformis muscle can cause all sorts of problems. Doroski Chiropractic Neurology in the Woodbridge, Dale City VA area wants to provide you with some information on piriformis syndrome.

Anatomy

The piriformis muscle originates from the anterior (front) part of the sacrum, the part of the spine in the gluteal region, and from the superior margin of the greater sciatic notch (as well as the sacroiliac joint capsule and the sacrotuberous ligament). It exits the pelvis through the greater sciatic foramen to insert on the greater trochanter of the femur. Its tendon often joins with the tendons of the superior gemellus, inferior gemellus, and obturator internus muscles prior to insertion.

The piriformis, pyramidal in shape, lying almost parallel with the posterior margin of the gluteus medius.

It is situated partly within the pelvis against its posterior wall, and partly at the back of the hip-joint.

It arises from the front of the sacrum by three fleshy digitations, attached to the portions of bone between the first, second, third, and fourth anterior sacral foramina, and to the grooves leading from the foramina: a few fibers also arise from the margin of the greater sciatic foramen, and from the anterior surface of the sacrotuberous ligament.

The muscle passes out of the pelvis through the greater sciatic foramen, the upper part of which it fills, and is inserted by a rounded tendon into the upper border of the greater trochanter behind, but often partly blended with, the common tendon of the obturator internus and superior and inferior gemellus muscles.

The piriformis muscle crosses over top of the sciatic muscle and if the muscle spasms it will compress the sciatic nerve and cause pain in to your buttock and leg. Once you have been properly diagnosed by your chiropractor or healthcare provider it is time to start treatment.

Treatment

Now that we know what the piriformis is and how it can cause us pain by compressing the sciatic nerve stretching it is one of the first things you should try. Video

Lie on the back with the legs flat. Pull the affected leg up toward the chest, holding the knee with the hand on the same side of the body and grasping the ankle with the other hand. Trying to lead with the ankle, pull the knee towards the opposite ankle until stretch is felt. Do not force ankle or knee beyond stretch. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.

Lie on the floor with the legs flat. Raise the affected leg and place that foot on the floor outside the opposite knee. Pull the knee of the bent leg directly across the midline of the body using the opposite hand or a towel, if needed, until stretch is felt. Do not force knee beyond stretch or to the floor. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.

Lie on the floor with the affected leg crossed over the other leg at the knees and both legs bent. Gently pull the lower knee up towards the shoulder on the same side of the body until stretch is felt. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.

These stretches work great for after care and between visits but active care may be needed by your chiropractor to help eliminate any other causes of the sciatic compression.

+scottdoroski3122/posts

+doroskichiropractic3122/posts

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

in Chiropractor by Doroski June 23, 2014 0 comments

Sciatica is a common term used to describe all sorts of back ailments. Patients come in to Doroski Chiropractic Neurology in Woodbridge VA with the self-diagnosis of sciatica all the time. 50% of the time they are right or their neighbor who had it before and told them that’s what it is, was right. Here is the information the ACA uses to define sciatica. Your local chiropractor is a great place to start and if you are in the Woodbridge Virginia area give us a call.

Sciatica describes persistent pain felt along the sciatic nerve, which runs from the lower back, down through the buttock, and into the lower leg. The sciatic nerve is the longest and widest nerve in the body, running from the lower back through the buttocks and down the back of each leg. It controls the muscles of the lower leg and provides sensation to the thighs, legs, and the soles of the feet.

Although sciatica is a relatively common form of low-back and leg pain, the true meaning of the term is often misunderstood. Sciatica is actually a set of symptoms—not a diagnosis for what is irritating the nerve root and causing the pain.

Sciatica occurs most frequently in people between the ages of 30 and 50 years old. Most often, it tends to develop as a result of general wear and tear on the structures of the lower spine, not as a result of injury.

What are the symptoms of sciatica?

The most common symptom associated with sciatica is pain that radiates along the path of the sciatic nerve, from the lower back and down one leg; however, symptoms can vary widely depending on where the sciatic nerve is affected. Some may experience a mild tingling, a dull ache, or even a burning sensation, typically on one side of the body.

Some patients also report:

• A pins-and-needles sensation, most often in the toes or foot

• Numbness or muscle weakness in the affected leg or foot

Pain from sciatica often begins slowly, gradually intensifying over time. In addition, the pain can worsen after prolonged sitting, sneezing, coughing, bending, or other sudden movements.

How is sciatica diagnosed?

Your doctor of chiropractic will begin by taking a complete patient history. You’ll be asked to describe your pain and to explain when the pain began, and what activities lessen or intensify the pain. Forming a diagnosis will also require a physical and neurological exam, in which the doctor will pay special attention to your spine and legs. You may be asked to perform some basic activities that will test your sensory and muscle strength, as well as your reflexes. For example, you may be asked to lie on an examination table and lift your legs straight in the air, one at a time.

In some cases, your doctor of chiropractic may recommend diagnostic imaging, such as x-ray, MRI, or CT scan. Diagnostic imaging may be used to rule out a more serious condition, such as a tumor or infection, and can be used when patients with severe symptoms fail to respond to six to eight weeks of conservative treatment.

What are my treatment options?

For most people, sciatica responds very well to conservative care, including chiropractic. Keeping in mind that sciatica is a symptom and not a stand-alone medical condition, treatment plans will often vary depending on the underlying cause of the problem.

Chiropractic offers a non-invasive (non-surgical), drug-free treatment option. The goal of chiropractic care is to restore spinal movement, thereby improving function while decreasing pain and inflammation. Depending on the cause of the sciatica, a chiropractic treatment plan may cover several different treatment methods, including but not limited to spinal adjustments, ice/heat therapy, ultrasound, TENS, and rehabilitative exercises.

An Ounce of Prevention Is Worth a Pound of Cure

While it’s not always possible to prevent sciatica, consider these suggestions to help protect your back and improve your spinal health.

• Maintain a healthy diet and weight

• Exercise regularly

• Maintain proper posture

• Avoid prolonged inactivity or bed rest

• If you smoke, seek help to quit

•Use good body mechanics when lifting

+scottdoroski3122/posts

+doroskichiropractic3122/posts

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link