How does prolonged sitting affect hip health. What are the common causes of hip pain from sitting. Which exercises can alleviate hip flexor discomfort. How to prevent hip pain while working at a desk. What lifestyle changes can improve hip flexibility and strength.

Understanding Hip Flexor Pain: Causes and Consequences

Hip flexor pain is a prevalent issue that affects many individuals, particularly those who spend long hours sitting. This discomfort can range from a dull ache to sharp pain, often exacerbated by prolonged periods of inactivity. To effectively address this problem, it’s crucial to understand its root causes and potential consequences.

Common Causes of Hip Flexor Pain

• Prolonged sitting
• Poor posture
• Weakness in hip muscles
• Overuse or repetitive motions
• Trauma or injury

When we sit for extended periods, our hip flexor muscles remain in a shortened position. Over time, this can lead to tightness, weakness, and imbalances in the hip region. Additionally, poor posture while sitting can further exacerbate these issues, placing undue stress on the hip joints and surrounding tissues.

Consequences of Untreated Hip Flexor Pain

If left unaddressed, hip flexor pain can lead to a variety of complications:

1. Reduced mobility and flexibility
2. Altered gait patterns
3. Increased risk of falls
4. Chronic lower back pain
5. Decreased quality of life

Is hip flexor pain always caused by sitting? While prolonged sitting is a significant contributor, other factors such as intense physical activity, sudden movements, or underlying medical conditions can also lead to hip flexor discomfort. It’s essential to consider all potential causes when seeking treatment.

The Anatomy of Hip Flexors: Key Muscles and Their Functions

To better understand hip flexor pain, it’s important to familiarize ourselves with the anatomy of this muscle group. The hip flexors are a collection of muscles that work together to flex the hip joint, allowing us to lift our legs and bend at the waist.

Primary Hip Flexor Muscles

• Iliopsoas (composed of the iliacus and psoas major)
• Rectus femoris
• Sartorius
• Tensor fasciae latae
• Pectineus

Among these, the iliopsoas is often considered the most significant hip flexor muscle. It originates from the lower back and pelvis, crossing the hip joint to attach to the femur. This unique positioning allows it to play a crucial role in both hip flexion and spinal stability.

How do hip flexors function during everyday activities? These muscles are engaged in various movements, including:

1. Walking and running
2. Climbing stairs
3. Rising from a seated position
4. Kicking or lifting the leg
5. Maintaining posture while standing

Understanding the anatomy and function of hip flexors is crucial for developing effective strategies to prevent and alleviate pain associated with prolonged sitting.

The Impact of Sedentary Lifestyles on Hip Health

In today’s modern world, sedentary lifestyles have become increasingly common. Many individuals spend hours each day sitting at desks, in cars, or on couches, often without realizing the potential impact on their hip health. This prolonged inactivity can lead to a range of issues affecting not only the hip flexors but also the surrounding muscles and joints.

Negative Effects of Prolonged Sitting

• Muscle shortening and tightness
• Reduced blood flow to the hips and legs
• Weakening of supporting muscles
• Increased pressure on spinal discs
• Altered biomechanics and posture

Can sitting for long periods cause permanent damage to hip flexors? While the human body is remarkably adaptable, chronic inactivity can lead to long-term changes in muscle length, strength, and function. However, with proper intervention and lifestyle modifications, many of these effects can be reversed or mitigated.

Breaking the Cycle of Inactivity

To combat the negative impacts of sedentary behavior, consider implementing the following strategies:

1. Set reminders to stand and move every 30-60 minutes
2. Incorporate brief stretching routines throughout the day
3. Use a standing desk or treadmill desk when possible
4. Take short walks during breaks or lunch periods
5. Practice active sitting techniques, such as using a stability ball or balance cushion

By making conscious efforts to reduce sitting time and increase movement throughout the day, individuals can significantly improve their hip health and overall well-being.

Effective Stretches and Exercises for Hip Flexor Relief

Addressing hip flexor pain often requires a combination of stretching and strengthening exercises. By incorporating these movements into your daily routine, you can improve flexibility, reduce tension, and build strength in the hip region.

Key Stretches for Hip Flexor Relief

• Kneeling hip flexor stretch
• Standing quad stretch
• Pigeon pose
• Butterfly stretch
• Figure-four stretch

How long should you hold each stretch? Generally, it’s recommended to hold static stretches for 15-30 seconds, repeating 2-4 times on each side. However, individual needs may vary, so it’s essential to listen to your body and adjust accordingly.

Strengthening Exercises for Hip Stability

1. Bridges
2. Clamshells
3. Side-lying leg lifts
4. Standing hip abductions
5. Banded walks

When performing strengthening exercises, aim for 2-3 sets of 10-15 repetitions, gradually increasing the intensity as your strength improves. Remember to maintain proper form throughout each movement to maximize benefits and minimize the risk of injury.

Is it safe to exercise with hip flexor pain? While gentle stretching and strengthening can often help alleviate discomfort, it’s crucial to approach exercise cautiously if you’re experiencing pain. If you’re unsure about which exercises are appropriate for your condition, consult with a physiotherapist or qualified healthcare professional for personalized guidance.

Ergonomic Solutions for Desk Workers: Minimizing Hip Strain

For individuals who spend significant time working at a desk, creating an ergonomic workspace is essential for maintaining hip health and preventing pain. By optimizing your work environment, you can reduce strain on your hip flexors and promote better posture throughout the day.

Key Elements of an Ergonomic Workstation

• Adjustable chair with proper lumbar support
• Desk at the correct height for your body
• Monitor positioned at eye level
• Keyboard and mouse at a comfortable height
• Footrest if feet don’t comfortably reach the floor

How does proper ergonomics benefit hip health? An ergonomically designed workspace helps maintain neutral spine alignment, reducing pressure on the hip flexors and surrounding muscles. This can prevent the development of imbalances and tension that often lead to pain and discomfort.

Implementing Active Sitting Techniques

In addition to setting up an ergonomic workstation, incorporating active sitting techniques can further promote hip health:

1. Use a stability ball as a chair for short periods
2. Try a balance cushion on your regular chair
3. Practice pelvic tilts while seated
4. Perform seated leg lifts or ankle rotations
5. Regularly shift your sitting position

By combining proper ergonomics with active sitting strategies, desk workers can significantly reduce the risk of developing hip flexor pain and other related issues.

Lifestyle Modifications to Support Hip Health

While targeted exercises and ergonomic adjustments are crucial for managing hip flexor pain, broader lifestyle modifications can also play a significant role in promoting overall hip health. By adopting habits that support your body’s natural movement patterns and reduce stress on the hip region, you can create a foundation for long-term well-being.

Incorporating Regular Movement

• Take frequent breaks to stand and walk
• Use a standing desk for part of your workday
• Practice yoga or gentle stretching routines
• Engage in low-impact cardiovascular activities
• Explore hobbies that encourage movement, such as gardening or dancing

How much movement is necessary for optimal hip health? While individual needs may vary, aim for at least 30 minutes of moderate physical activity most days of the week. This can be broken up into shorter sessions throughout the day if needed.

Nutritional Support for Joint Health

A balanced diet rich in anti-inflammatory foods can support hip health and reduce the risk of pain and stiffness. Consider incorporating the following nutrients into your diet:

1. Omega-3 fatty acids (found in fish, flaxseeds, and walnuts)
2. Antioxidants (abundant in colorful fruits and vegetables)
3. Vitamin D and calcium (for bone health)
4. Collagen-rich foods (such as bone broth and lean proteins)
5. Hydration (aim for adequate water intake throughout the day)

By combining regular movement with a nutrient-dense diet, you can create a holistic approach to supporting your hip health and overall well-being.

When to Seek Professional Help for Hip Flexor Pain

While many cases of hip flexor pain can be effectively managed through self-care strategies, there are instances where professional intervention may be necessary. Recognizing when to seek help is crucial for preventing chronic issues and ensuring appropriate treatment.

Signs That Indicate the Need for Professional Assessment

• Persistent pain lasting more than a few weeks
• Pain that interferes with daily activities or sleep
• Sudden onset of severe pain
• Pain accompanied by swelling, redness, or warmth
• Numbness, tingling, or weakness in the leg

What types of healthcare professionals can help with hip flexor pain? Depending on the nature and severity of your condition, you may benefit from consulting:

1. Physiotherapists
2. Chiropractors
3. Orthopedic specialists
4. Sports medicine physicians
5. Massage therapists

These professionals can provide a comprehensive assessment of your condition, develop a personalized treatment plan, and guide you through appropriate exercises and therapies to address your specific needs.

Diagnostic Approaches for Hip Flexor Pain

When seeking professional help, your healthcare provider may use various diagnostic tools to assess your condition:

• Physical examination
• Range of motion tests
• Strength assessments
• Imaging studies (X-rays, MRI, or ultrasound)
• Gait analysis

By accurately diagnosing the underlying cause of your hip flexor pain, healthcare professionals can develop targeted interventions to address your specific condition and promote optimal healing.

Remember, early intervention is often key to preventing chronic issues and achieving a full recovery. If you’re experiencing persistent or concerning symptoms, don’t hesitate to seek professional guidance for your hip flexor pain.

How To Relieve Hip Pain From Too Much Sitting

Do you suffer from hip pain? A constant aching after sitting down all day at your desk or when you try to enjoy your favourite movie or show?

You’re not alone. Hip pain is a common, frustrating and debilitating condition that affects many of us every day. It doesn’t discriminate. Whether you’re a desk jockey working from home staring at another Zoom meeting, or driving trucks up and down the Hume. Hip pain from too much sitting can get anyone.

Hip pain can be due to any of the following.

• Tight and weak hip muscles
• Referred pain from your lower back
• Hip joint issues (like arthritis)
• And many more

As your physiotherapist in Pascoe Vale I’ve seen quite a few sore hips from sitting down longer than we used to. Here’s a few quick tips and tricks that you can do at home to help prevent hip pain from occurring frequently. You’ll also be able to move more and improve your overall hip health in the long run.  

First, here’s what happens when you sit for too long and get hip pain.

Prolonged periods of sitting, especially in one position, can often be a source of hip pain and can be a trigger for other hip conditions. 

Some tissues (muscles and tendons) can get squished, and others are put in a position they don’t like to be in for many hours. Over time this can lead to tightness, weakness and over stress which can all contribute to your pain.

Understanding your body and learning concepts that can help alleviate your pain can go a long way in helping you do the things you enjoy without having that lingering pain. By implementing these strategies, you can expect to feel less pain in your hips, feel stronger in your hips, and feel more confident in doing the things you enjoy. 

But unfortunately, life gets in the way at times. You often find it difficult to implement these strategies due to time constraints, limited by the pain itself or simply forgetting.  

Here’s the mistakes which we’ve all made in the past

You might have heard about how to relieve your hip pain before but been unable to make the changes needed. That’s normal! Many of us take a few cracks at getting these new habits and exercises down pat.

These are the main mistakes that we have to overcome.

• Being unsure of what and how to do your exercises stretches that will help you
• Afraid to move in case you make your hip pain worse 
• Not having support and a lack of motivation 
• It’s too damn sore!

But not to worry, we got you covered. Here are some simple strengthening and stretching exercises that are safe, and can be done at practically any time and anywhere. 

Relieve hip pain with a piriformis stretch 

The piriformis is a deep gluteal (bum) muscle that makes up part of the lateral rotators of the hip. It’s important for balance when you walk, or when you sit, your piriformis holds your legs straight and assists keeping you upright.

If this muscle becomes tight, it exerts pressure onto your sciatic nerve, which can produce pain radiating into your leg. Stretching this muscle can help relieve some of the added tension. 

To begin the stretch, start off in a seated position with the leg of the affected side crossed over your opposite knee. Apply gentle pressure to the knee as you lean forward, increasing the depth of the stretch. Hold this position until you feel a comfortable tension with no pain.

Do hip abduction exercises standing behind your chair to help relieve hip pain

Your hip abductors work together to help keep your hips stable when you move.

Hip abduction strength is one of the most common weaknesses seen in individuals with hip pain. Weakness in this region can also cause effects down your leg into your foot and ankle. Prolonged sitting is a high risk factor for developing hip abductor weakness. 

The extended period of inactivity can lead to tightness in these muscles which inhibits their ability to function effectively.  

A great exercise to perform at home is the standing hip abduction. Stand behind your chair, just touching gently for balance. Pull your leg out and away from your body but make sure you don’t lean your hips. Stand tall and then slowly bring your feet back together again. Avoid letting your knees touch, you only need to lift your legs around 30-40 degrees to be able to feel this and work those muscles.

Complete up to 10 reps on each side.

Hip flexor stretch and strength exercise for hip pain

Prolonged periods of sitting places the hip flexors, which are the muscles at the top and front aspect of your thigh, into a shortened position. 

As a result, these muscles can become tight and weak, which ultimately leads to hip pain.  

A great exercise that can be done to stretch, but more importantly strengthen the hip flexors is the lunge. As one leg goes down, that side of the hip flexors is being stretched, while the other is being strengthened. 

To perform a lunge, stand up straight with your hands on your hips and take a large step forwards onto one leg. Bend your knees, lowering your hips down between both feet until your knees are bent to 90 degrees. Push back up to your starting position. 

That’s it. There’s 3 simple exercises you can do at home to relieve hip pain from too much sitting.

Of course, there’s plenty of other more specific and targeted things we can do as your physiotherapists in Pascoe Vale to help out further. If you have hip pain, start with these exercises and then make an appointment with us in clinic to get you moving again.

About the Author

Pascoe Vale’s physiotherapist Mouhamed Ziftawi doesn’t want you to be struggling alone with hip pain. If you do, that’s ok. Start of with these exercises and book in a session to get your personal plan with the care and guidance you need to overcome your sore hip. If you’d like to learn a little more about Mouhamed check out his interview.

5 Ways to Reduce Hip Flexor Pain When Sitting at Your Desk

If you’re reading this, my guess is that you have a desk job of some kind. A job that requires you to sit all day (or most of the day) – which means you are sitting far too long. That long day at a desk could cause hip flexor pain when sitting.

Many of us are familiar with the idea of back and neck pain from sitting at a desk, but can sitting all day cause hip pain too?

Unfortunately, yes.

Hip flexor pain when sitting is an all too common problem, especially now that more of us are working from home.

Unless you are able to integrate intentional movement into your work day, you may begin to experience hip flexor pain when sitting. This pain can impact other areas of your body, causing low back pain and influencing your posture as well.

When at the office, you get up to walk to a coworker’s desk, make copies, or walk down the block to grab lunch.

But when you’re working from your home office or kitchen table, the only thing you are bouncing between is Zoom meetings and emails. (And you know your snack or lunch is just a few steps away.)

So even though you may seem to have more freedom when working from home – you’re probably in your seat even more. And that could spell bad news for hip flexor pain when sitting.

What causes hip flexor pain when sitting?

Put simply, hip flexor pain when sitting is caused because you are in the same position for hours at a time – making the hip flexor muscles tighten and shorten.

Your hip flexor muscles are made up of your iliacus and the psoas muscles and are together known as the iliopsoas. These hip muscles rarely get any rest, and although you may feel that sitting is a resting position, your hip flexors are still engaged.

When you are sitting, the iliacus holds your pelvis in line with your thigh bone and the psoas holds your spine in place so you can sit up straight. In fact, when they are kept in this position, they are in a shortened position.

Staying in a shortened position for long periods of time can cause muscle knots and cramps that creep into the inside of your hip, outside of your hip, and even your glute area and low back.

You also may notice that you begin to slouch more as the day goes on. Gravity encourages us to slouch while we are sitting, and slouching actually takes some pressure off of your hip flexor muscles so they are not working quite as hard. But that doesn’t make slouching a good thing!

Even though the iliopsoas may be getting a bit of a break when you slouch, your lower back and upper body start to suffer if you have bad body posture while sitting. Sitting up straight may cause the iliopsoas to shorten, but it is still more optimal than slouching.

The reason being is that you can use a few of the suggestions I gave above to lessen your hip pain while sitting.

When you work a job that requires you to sit for long periods of time, especially if you can’t choose your breaks, as each day passes the stress will build on your iliopsoas muscles.

As they shorten more and continue to contract in that shortened position, muscle knots and muscle tension will begin to cause you hip flexor pain when sitting. You may even begin to experience hip pain when standing up after sitting if the iliopsoas muscle tightness is never addressed.

The good news is that you don’t have to live with hip flexor pain when sitting forever. There are many ways to treat and alleviate hip pain, and one of them is knowing a few ways to reduce pain when sitting at your desk or kitchen table.

Here are five ways that you can reduce your hip flexor pain when sitting so you can enjoy a pain-free day at work.

5 ways to reduce hip flexor pain when sitting

There are many dangers in sitting too much too often, and one of them is long-lasting hip pain or low back pain. Here are five ways that you can reduce your hip flexor pain when sitting.

1. Invest in an ergonomic workstation

A big part of the problem with our work day is that we sit in one position for too long. That’s why I suggest investing in an ergonomic workstation. This could look different for everyone and you should modify it to fit your needs.

Some companies may be willing to improve worker productivity by adding some ergonomic workstation solutions, but if you work from home you have more options and control over your environment to an extent.

There are plenty of options other than the standard desk and chair, including:

• Standing desk
• Desk with multiple heights to move from sitting to standing
• Treadmill desk
• Using an exercise ball as a chair
• Other ergonomic chair options

When designing a workstation to alleviate lower back and hip pain when sitting, you need to be able to change positions throughout the day. It can be helpful to work from home so you can create an environment that encourages movement and change throughout the day.

Even if you have a standing desk, it isn’t necessarily good for your body to stand all day long either. Your muscles need breaks from time to time and can be strained if they are stuck in the same position for too long.

The other aspect to consider is your body alignment and the way you are sitting. Try to find the best sitting position for hip pain. Even if you are changing positions throughout the day, your body alignment can impact how you feel at the end of your work day.

Whether you are seated or standing, find a way to maintain your posture and keep your head erect as you look at your computer screen. This may mean a platform for your laptop or a drawer for your keyboard. Whatever you need to encourage proper posture and less strain on your body.

2. Take breaks to stretch

Never underestimate how even the smallest stretch can impact your day. Taking even five minutes to stand up and stretch or even perform stretches seated at your desk for 10-30 seconds at a time can improve your posture and mindset.

Since we are focusing on hip flexor pain when sitting, standing up and moving your hips is encouraged here, but stretching your back and legs is equally as important.

Standing up (or kneeling on the ground) and doing a gentle lunge stretch to bring some movement to the hip area is great, but be careful not to over do it. There are a number of gentle hip flexor stretches for tight hips that should create almost immediate relief. You should be looking for a gentle pull (like when you wake up in the morning and do a big stretch before getting out of bed), but never any pain.

While your hip flexor pain when sitting is likely caused by tight muscles, that doesn’t mean that stretching is what will cure the pain. Over stretching tight muscles right after sitting can do more harm than good, which is why only a small amount of gentle stretching is encouraged.

3. Make time to go on walks and move your body

As I have already mentioned, movement is the key to keeping your hips happy. When you are in an office, this can look like taking a break every hour to walk over and refill your water, delivering a piece of mail on the other side of the building, or dropping off some information at someone else’s desk/office.

When you are at home, you may have more room or time to plan out some time for walks and movement during your work day. If you have a dog or a small child at home with you, they too will benefit from getting out of the house during the day.

Walks don’t have to be long, they can even simply be around a block or two. The idea is to get your iliopsoas muscles into a new position and do a new activity for a little while so they do not freeze up and shorten so much that muscle knots or trigger points are created.

Try to fit in at least two shorts walks into your work day and then after work you can integrate other targeted exercises or longer walks.

4. Space out and stagger tasks if you can

If you have a job that requires meetings, emails, phone calls, and other types of tasks, try to build a schedule that mixes up the type of activity you are doing. Try to avoid doing the same activity the entire day.

An example of this is if you have a project you are working on, work on that project for a specified amount of time, but then try to schedule a phone call in between that project work and answering emails.

During your phone call, get up from your desk and maybe walk around the house or the office just to mix up your body positioning and add a bit more movement to the day. Then, after the phone call, you can return to your desk and answer the emails.

These types of changes in tasks can help you build habits that remind you to move your body or change body position.

5. Create a before and after work routine to alleviate hip pain

Part of the problem for many people reading this article is that they discover that the amount of sitting they do for work is what is causing their hip pain only once their pain has become chronic.

Having hip flexor pain when sitting means that you’ve already developed tight iliopsoas muscles and now you need a way to reverse that pain.

Stretching and massages may alleviate some pain in the moment, but they will not address the issue of tight muscles head on. To truly address tight hip flexor muscles, you need to teach your muscles how to relax.

The only way that muscle knots and general muscle tension can relax is by applying prolonged pressure. The problem is that the location of the iliacus and psoas make it very difficult to perform a pressure release.

That’s exactly why I invented the Hip Hook. If you’ve gone to a physical therapist for your hip pain, then you may be familiar with the pressure release they are able to perform on the psoas and iliacus muscles (your hip flexors). The Hip Hook allows you to perform that same targeted pressure from the comfort of home.

For best results with the Hip Hook, it helps to create a routine that allows you to use it daily (or every other day) to start. It doesn’t take long to achieve a muscle release of the psoas and iliacus muscles (only about 30-90 seconds) if you are using the Hip Hook correctly. You can use it longer than that, but when you are first starting out, it is recommended to take it easy and work up to longer periods with time.

For some people, using the Hip Hook before they’ve had a chance to workout or before starting a long day at work is what works best. For others, they may prefer to use the Hip Hook right after getting home. And others still prefer to use it before going to bed. Or all of the above!

No matter when you decide to use it, the main thing you need to do is create a sustainable routine that allows you to be consistent with use.

Over time, your hip flexor pain when sitting will dramatically improve, and other pain in your knees or back may also be impacted positively by your hip release exercises.

Frequently asked questions about hip pain when sitting at your desk

How do I know if my hip pain is arthritis, bursitis, or a hip flexor issue?

Getting to the root cause of your hip pain often requires a medical diagnosis. You can often narrow down possibilities by evaluating and recording your symptoms throughout the day – such as when they seem to worsen and where you specifically feel pain or stiffness.

You can choose to work with a physical therapist to treat symptoms and to help differentiate between the possible causes of the pain. For some people, there may also be a combination of two different conditions contributing to their hip pain.

Will sitting in a saddle chair help my hip pain when sitting?

Saddle seats or stools position your hips in a wide stance with your knees apart. The thought is that this position stabilizes the pelvis in an upright position to help to correct alignment and spinal orientation.

Sitting in a saddle chair isn’t necessarily feasible for the entire workday, but it could be included as a part of your workday as you change positions often. Saddle chairs may be uncomfortable at first as your hip readjusts to this new position, and they may not be ideal for everyone.

When should I see a doctor for my hip pain?

If you are experiencing hip pain, you should feel empowered to visit the doctor at any time. If you are unsure whether or not it is necessary to pay the doctor a visit, consider if your hip pain is interfering with your daily life in any way.

Does your hip pain prevent you from getting a good night’s sleep? Does it interfere with your workday productivity? Does hip pain stop you from doing your favorite activities?

If you answered yes to any of these questions, then you should absolutely consider visiting a doctor to get a diagnosis and treatment plan for your hip pain.

Ischialgia: symptoms, diagnosis, treatment of sciatica

Ischialgia (Sciatica) – pain in the lower back, spreading along the posterior-outer surface of the thigh to the lower leg and foot.

6 main causes of sciatica

Various diseases of the lumbar spine can cause sciatica. Sciatica is often described as moderate to severe pain in the legs. It is caused by compression of one or more of the five pairs of nerve roots in the lumbar spine. Doctors sometimes refer to sciatica as radiculopathy. Radiculopathy is a medical term used to describe pain, numbness, tingling, and weakness in the arms or legs caused by nerve root problems. If the nerve problem is in the cervical region, then this condition is called cervical radiculopathy. Since sciatica affects the lumbar region, it is also called lumbar radiculopathy.

Causes of pain

The 5 pairs of nerve roots in the lumbosacral region unite to create the sciatic nerve. Starting at the back of the pelvis (sacrum), the sciatic nerve travels behind the buttocks and down through the hip joint to the lower extremities. Nerve roots are not separate structures, but part of the overall nervous system of the body, capable of transmitting pain and sensations to other parts of the body. Radiculopathy is caused by compression of the nerve root, rupture of the disc, or growth of bone in the gap before it joins the sciatic nerve.

Sciatic nerve compression

Certain types of spinal disorders can cause spinal nerve compression and sciatica or lumbar radiculopathy. The 6 most common ones are listed below:

• disc herniation;
• stenosis of the lumbar spine;
• spondylolisthesis;
• trauma;
• piriformis syndrome;
• spinal tumors.

Protrusion or herniated disc

Disc protrusion is a condition when the central gel-like part of the disc (nucleus pulposus) protrudes towards the spinal canal, while the integrity of the outer wall of the disc (annulus fibrosus) is not violated. A herniated disc is formed when the nucleus pulposus extends beyond the annulus fibrosus. With a protrusion or herniated disc, the protruding part of the disc can compress the adjacent nerve root and cause sciatica. The consequences of a herniated disc are worse. In this case, the prolapsed disc nucleus not only causes direct compression of the nerve root, but at the same time, the substance of the disc contains an acid, a chemical irritant (hyaluronic acid), which causes inflammation of the nerve. Nerve compression and irritation cause inflammation and pain, often resulting in limb numbness, tingling, and muscle weakness.

Lumbar stenosis

Spinal stenosis is manifested by nerve compression and most often affects people of mature age. Pain in the lower extremities, similar to sciatica, may be the result of stenosis of the spinal canal of the lumbar spine. The pain is usually positional, manifested by changing position of the body, standing up or walking, and relieved by sitting. Nerve roots branch off from the spinal cord and exit through the foramen, bounded by bones and ligaments. Nerve roots emerge from these openings and innervate other parts of the body. When these openings become narrow and cause compression of the nerve, the term foraminal stenosis is used.

Spondylolisthesis

Spondylolisthesis most commonly affects the lumbar spine. In this case, the overlying vertebra is displaced in relation to the underlying one. When the vertebra slips and shifts, the nerve root is pinched, which causes sciatica pain in the legs. Spondylolisthesis is divided into congenital and acquired (due to degenerative changes, trauma, physical activity or heavy lifting.

Trauma

Sciatica may result from direct compression of the nerve root caused by external forces on the lumbosacral spine. For example, in case of a road traffic injury, a fall, etc. This exposure can damage nerves when broken bone fragments compress the nerves.

Piriformis syndrome

This syndrome is named after the piriformis muscle and the pain is caused by irritation of the sciatic nerve by this muscle. The piriformis muscle is localized in the pelvic region, connects the femur and is involved in the rotation of the thigh. The sciatic nerve passes under the piriformis muscle. Piriformis syndrome develops when this muscle spasms, thus compressing the sciatic nerve. Due to the insufficient information content of X-rays and magnetic resonance imaging, the diagnosis of this pathology is difficult.

Spinal tumors

Tumors of the spine are characterized by abnormal tissue growth and are divided into benign and malignant. The incidence of spinal tumors is quite rare. However, with the development of a tumor of the lumbar spine, there is a risk of developing sciatica due to compression of the nerve root.

Treatment of sciatica

To create a treatment plan, diagnostics is required, including a neurological examination, x-ray and magnetic resonance imaging. Depending on the cause of sciatica, there are several treatment options. Conservative therapy includes activity modification, physiotherapy, anti-inflammatory therapy and various types of blockade to relieve inflammation of the nerve root. Surgical treatment includes removal of a herniated disc through a small incision (microdiscectomy), and in case of stenosis, a decompressive operation with partial or complete removal of the vertebral arch (laminectomy).

Get expert advice from a specialist by contacting NCC No. 2 (Central Design Bureau of the Russian Academy of Sciences). You should not postpone making an appointment with a neurologist if any alarming symptoms appear. We remind you that early diagnosis allows you to stop the problem at an embryonic level. You can make an appointment at the Central Clinical Hospital of the capital by phone or using the form on the website.

Piriformis syndrome symptoms and treatment

CGM is a pathology of the musculoskeletal system with a powerful pain syndrome in the buttock area, as well as its irradiation to nearby areas.

The piriformis muscle (from Latin – musculus periformis) is located under the layer of the gluteus maximus muscle and passes through the ischial foramen. At one end it is attached to the sacrum, and at the other end to the greater trochanter of the femur. Its function is to externally rotate the hip (rotation) during extension and abduction of the hip during flexion. Reflex tension and neurodystrophic process in it often occurs when the L5-S1 roots are irritated.

If the cause of the disease is not detected at the initial stage, the symptom complex of the piriformis muscle can progress quite quickly, leading to sciatica.

Symptoms

The clinical picture consists of three signs:

• local;
• indicating damage to the adjacent nerve of the sacral plexus;
• compression of the vessels of the sciatic nerve, as well as the lower gluteal artery.

It is precisely for this reason that three types of manifestations of the disease can be observed. Local symptoms include aching pain in the buttock region, radiating along the back of the thigh and lower leg, as well as pain in the hip and sacroiliac joints. When the position changes, the pain syndrome does not disappear. With prolonged sitting in place, it intensifies. You can get relief only lying down, or sitting with your legs apart.

The second group of symptoms includes “dull” pain with a burning sensation or chilliness radiating throughout the limb. With significant compression of the nerve by the pathologically altered piriformis muscle and sacrospinous ligament, weakness of the leg flexors, foot paresis, decreased sensitivity in the lower leg and outer edge of the foot, decrease or loss of the Achilles reflex, autonomic disorders on the lower leg and foot are possible. And if the vessels of the sciatic nerve and the lower gluteal artery are affected, there are difficulties when walking – a person takes a forced position of the body, periodically has to stop or sit down.

Etiology

Usually the causes of pathology are primary and secondary. Primary – if the disease is caused by damage to the muscle tissue itself. Among them:

• stretching or excessive stress during training;
• hypothermia;
• injuries to the gluteal or lumbar regions;
• piriformis myositis;
• incorrect injection;
• prolonged stay in antalgic, that is, a forced position.

Secondary causes of CGM are pathologies of the pelvic organs and problems in the connective structure of the ilium and sacrum.

There is another number of factors for the onset of the disease. These are vertebrogenic and non-vertebrogenic causes, that is, related to the region of the spine.

Vertebrogenic:

• injuries of the spinal cord or spine;
• lumbar radiculopathy;
• narrowing of the intervertebral foramen;
• spinal tumors.

Non-vertebrogenic include: referred pain in diseases of other internal organs, as well as myofascial pain syndrome.

Diagnostics

In the examination, it is important that the nerve is compressed below the place where the nerve branches originate to the gluteus medius and minimus muscles and the muscle that stretches the fascia lata of the proximal part of the femur, so EMG reveals their intactness. Transrectal palpation should be performed and the patient checked for the following symptoms:

• Freiberga – when the bent hip is rotated inward, the affected piriformis muscle gives pain;
• Pace’s symptom – in a lying position on a healthy side, the side of the diseased side is raised, when the leg bent at the knee is raised, pain appears;
• Bonnet-Bobrovnikova – with complete relaxation of the muscles, passive rotation of the thigh inward;
• Beatty’s symptom – in the lying position on the healthy side, when raising the straight leg up, there is pain in the buttock;
• Mirkina – detection of pain when bending forward with straight legs.

In addition, the range of motion is studied.

Novocaine blockade of the S1 root and the piriformis muscle is not the least important in the diagnosis. The subsequent weakening or reduction of pain along the sciatic nerve indicates that discomfort is not caused by neuritis, but by its compression.

For complete examination and for differential diagnosis:

• electroneurography – to analyze the condition of the muscles of the lower limb and conduction of the sciatic nerve;
• computed tomography – to obtain a three-dimensional image of the insides;
• radiography of the hip joints;
• Ultrasound of the pelvic organs.

The specificity of the muscle under study is such that manual methods of diagnosis are of no small importance in its examination.

In addition to all of the above, differential diagnosis is carried out with pathologies that have similar symptoms. For example, it is necessary to exclude the presence of an intervertebral hernia.