What is piriformis syndrome. How does it differ from other causes of sciatica. What are the most effective diagnostic tests and treatments for piriformis syndrome. How can you prevent this condition from developing or recurring.

Understanding Piriformis Syndrome: A Comprehensive Overview

Piriformis syndrome is a complex condition that occurs when the sciatic nerve becomes irritated as it passes near or through the piriformis muscle. This muscle, shaped like a flat pyramid, originates from the front of the sacrum and attaches to the greater trochanter of the femur. The close proximity of the piriformis muscle to the sciatic nerve can lead to nerve compression when the muscle contracts or becomes enlarged due to overuse.

Interestingly, in about 10% of cases, the sciatic nerve actually runs through the piriformis muscle, making it more susceptible to compression. This anatomical variation can significantly increase the risk of developing piriformis syndrome.

Key Symptoms of Piriformis Syndrome

• Aching, burning, or sharp pain in the area innervated by the sciatic nerve
• Pain originating in the mid-buttocks on one side
• Pain radiating down the upper leg, sometimes reaching the knee
• Rarely, pain extending past the knee to the foot (more common in herniated disc cases)

Causes and Risk Factors of Piriformis Syndrome

Various factors can contribute to the development of piriformis syndrome. Understanding these causes can help in prevention and management of the condition.

Common Causes of Piriformis Syndrome

• Trauma to the buttock or sacroiliac area
• Repetitive overuse of the piriformis muscle
• Presence of myofascial trigger points
• Anatomical variations in muscle or nerve structure
• Postural factors and biomechanical imbalances
• Leg length discrepancy

How do certain habits increase the risk of piriformis syndrome? Activities that put strain on the piriformis muscle can lead to its irritation and subsequent compression of the sciatic nerve. These include:

• Standing predominantly on one leg
• Sitting on one foot or with legs crossed
• Habitual standing with the hip turned outward (external rotation)
• Walking with legs too close together or with internal leg rotation

Diagnostic Challenges and Clinical Indicators

Diagnosing piriformis syndrome can be challenging due to its similarity with other conditions causing sciatica. There is no single definitive test for piriformis syndrome, making it a diagnosis of exclusion in many cases.

Six Key Indicators of Piriformis Syndrome

1. History of trauma to the buttock or sacroiliac area
2. Pain in the sacroiliac joint or piriformis muscle region
3. Pain exacerbated by stooping or lifting, relieved with spinal traction
4. Presence of a palpable soft nodule near the sacroiliac joint
5. Positive straight leg raise test
6. Atrophy of the gluteal muscles

How do healthcare providers differentiate piriformis syndrome from other conditions? A comprehensive approach is necessary, including:

• Detailed patient history and symptom analysis
• Specific clinical tests
• Imaging studies such as CT scans or MRIs to rule out other conditions

Diagnostic Tests for Piriformis Syndrome

Several clinical tests are employed to diagnose piriformis syndrome, each designed to stretch the piriformis muscle and reproduce the patient’s symptoms.

Common Diagnostic Tests

• Straight-leg raise test
• Pace test
• Freiberg test
• Flexion, adduction, and internal rotation (FAIR) test
• Beaty test

Which test is most effective in diagnosing piriformis syndrome? Studies indicate that the FAIR test has the highest sensitivity and specificity for identifying piriformis syndrome. This test involves flexing, adducting, and internally rotating the affected leg to stretch the piriformis muscle and potentially reproduce the patient’s symptoms.

Effective Treatment Strategies for Piriformis Syndrome

The primary goal of treatment for piriformis syndrome is to alleviate pressure on the sciatic nerve by addressing the underlying muscle dysfunction.

Conservative Treatment Approaches

• Stretching exercises to lengthen the piriformis muscle
• Deep heat therapy (ultrasound) to improve tissue elasticity before stretching
• Manual therapy techniques to release muscle tension
• Correction of biomechanical imbalances
• Addressing leg length discrepancies if present

Why is stretching considered the cornerstone of piriformis syndrome treatment? Stretching exercises aim to lengthen the piriformis muscle, thereby reducing compression on the sciatic nerve. This approach not only alleviates symptoms but also helps prevent recurrence by improving muscle flexibility and function.

The Role of Physical Therapy in Managing Piriformis Syndrome

Physical therapy plays a crucial role in the comprehensive management of piriformis syndrome. A tailored physical therapy program can address multiple aspects of the condition, promoting recovery and preventing future episodes.

Key Components of Physical Therapy for Piriformis Syndrome

• Customized stretching routines
• Strengthening exercises for surrounding muscles
• Posture correction and ergonomic advice
• Manual therapy techniques
• Gait analysis and correction
• Education on proper body mechanics

How does physical therapy contribute to long-term management of piriformis syndrome? By addressing not only the immediate symptoms but also the underlying biomechanical issues, physical therapy helps patients achieve lasting relief and reduce the risk of recurrence. Therapists can provide valuable guidance on maintaining proper posture, ergonomics, and movement patterns in daily activities.

Advanced Treatment Options for Refractory Cases

While conservative measures are often effective, some cases of piriformis syndrome may require more advanced interventions.

Advanced Treatment Modalities

• Corticosteroid injections
• Botulinum toxin injections
• Dry needling or acupuncture
• Radiofrequency ablation
• Surgical decompression (in rare, severe cases)

When should advanced treatments be considered for piriformis syndrome? Advanced interventions are typically reserved for cases that do not respond to conservative management after several weeks or months. The decision to pursue these options should be made in consultation with a specialist, considering the individual patient’s symptoms, functional limitations, and overall health status.

Preventing Piriformis Syndrome: Lifestyle and Ergonomic Considerations

Prevention is key in managing piriformis syndrome, especially for individuals at higher risk due to their activities or anatomical predispositions.

Preventive Strategies for Piriformis Syndrome

• Regular stretching and strengthening exercises
• Maintaining proper posture during sitting and standing
• Using ergonomic chairs and workstations
• Avoiding prolonged sitting or standing in one position
• Proper warm-up before physical activities
• Wearing appropriate footwear
• Addressing leg length discrepancies with orthotics if necessary

How can individuals incorporate preventive measures into their daily routines? Simple strategies like taking regular breaks to stretch during long periods of sitting, practicing good posture, and engaging in balanced exercise routines can significantly reduce the risk of developing piriformis syndrome. For those with physically demanding jobs or sports activities, proper body mechanics and technique are crucial in preventing overuse and strain of the piriformis muscle.

The Importance of Comprehensive Care in Piriformis Syndrome Management

Effective management of piriformis syndrome often requires a multidisciplinary approach, combining various treatment modalities and lifestyle modifications.

Elements of Comprehensive Care

• Accurate diagnosis through thorough clinical evaluation
• Customized treatment plans addressing individual patient needs
• Regular follow-up and adjustment of treatment strategies
• Patient education on self-management techniques
• Addressing related biomechanical issues
• Collaboration between healthcare providers (e.g., physiotherapists, orthopedic specialists, pain management experts)

Why is a comprehensive approach crucial in managing piriformis syndrome? Given the complex nature of piriformis syndrome and its potential impact on daily life, a holistic treatment approach ensures that all aspects of the condition are addressed. This comprehensive care not only aims to alleviate current symptoms but also focuses on long-term management and prevention of recurrence.

In conclusion, piriformis syndrome represents a challenging but manageable condition affecting the sciatic nerve. Through a combination of accurate diagnosis, targeted treatment, and preventive measures, individuals suffering from this syndrome can find relief and improve their quality of life. As research in this field continues to evolve, new insights and treatment modalities may further enhance our ability to effectively manage piriformis syndrome.

Piriformis Syndrome: What To Do?

Piriformis syndrome: what is it? How do you get it? How do you know you have it? How do you get rid of it? What else do you need to know? That’s the substance of this review article written by two well-known and well-respected physiotherapists on the subject of piriformis syndrome.

Let’s start with: what is the piriformis syndrome? Piriformis syndrome is an irriation of the sciatic nerve as it passes next to or through the piriformis muscle. The piriformis muscle is a flat, pyramid-shape structure. It starts along the anterior (front) part of the sacrum and inserts or attaches on the greater trochanter of the femur. That’s a bony bump at the top of the upper thigh bone.

The muscle is close enough to the sciatic nerve that the muscle can put pressure on the nerve when it contracts or if it gets bulky enough from repetitive overuse. In about 10 per cent of all cases, the sciatic nerve actually runs through the piriformis muscle. Anytime the muscle contracts, the nerve gets squeezed.

Some experts think it’s this pressure that causes the symptoms that make up piriformis syndrome. Those symptoms include aching, burning, or sharp pain in the area controlled by the sciatic nerve. The pain starts in the mid-buttocks on one side and can shoot down the upper leg. Symptoms may go down as far as the knee but only occasionally go past the knee. How far down the leg the pain goes can help distinguish it from a herniated disc. Pain that does go past the knee down to the foot is more likely to be from a protruding disc putting pressure on the spinal nerve root.

Before going much further, it’s important to say there are some medical specialists who don’t believe the piriformis syndrome even exists. So, some effort has been put into identifying just what constitutes the idea of a piriformis syndrome. Here are six indicators of this condition:

• History of trauma to the buttock or sacroiliac area
• Pain in the sacroiliac joint or area of the piriformis muscle
• Pain that’s made worse by stooping or lifting and relieved with spinal traction
• A soft nodule that is easily felt in the area of the SAI joint
• A positive straight leg raise test
• Atrophy or wasting of the buttock (gluteal) muscle  

Besides trauma, what else can cause this problem? Repetitive overuse of the muscle, myofascial trigger points, anatomic variations, postural factors, and a difference in leg length. The risk of developing piriformis syndrome increases any time someone stands on one leg more than the other, sits on one foot, sits crossed-leg, or stands habitually with the hip turned out (external rotation. Walking with the leg too close to the other leg and with internal rotation of the leg can also increase the strain on this muscle resulting in piriformis syndrome.

How can you know for sure that you have this thing called piriformis syndrome? It’s not always easy. There are many other possible causes of sciatica and there isn’t one test that separates piriformis syndrome from other problems. Sciatica is also caused by tumors, lumbosacral strain, lumbar disc herniation, and spinal stenosis (narrowing of the spinal canal around the spinal cord).

Most often, the examiner must ask lots of questions about history and symptoms, perform some specific clinical tests, and sometimes order special tests such as a CT scan or MRI. They say the diagnosis is really one by exclusion. That means when all other conditions have been ruled out, piriformis can be ruled in. Some of the more common tests performed include reflexes, straight-leg raise, the Pace test, Freiberg test, flexion adduction and internal rotation (FAIR) test, and the Beaty test.

The authors describe each test and offer what they could find in the literature to say which tests are the most valid, reliable, sensitive, and specific. Most of these tests place the patient’s leg in different positions to stretch the piriformis muscle and see if the painful symptoms are reproduced. Studies show that the FAIR test has the best chance of ruling in piriformis syndrome. The test procedure of stretching the muscle is also the most commonly prescribed treatment program.

Stretching to lengthen the muscle is believed to be the best way to decrease the compression put on the sciatic nerve when the piriformis contracts. Sometimes a form of deep heat called ultrasound is used by physiotherapists before starting the stretching exercises. This has been shown to alter the connective tissue bonds enough to allow them to break so that the muscle fibers lengthen during the stretching procedure.

It’s important to check the patient for any other biomechanical reasons for piriformis syndrome. For example, having a leg-length difference (one leg longer than the other) can be a contributing factor. The examiner will review your risk factors. A previous history of cancer (especially cancers that spreads to the bone) is important. The presence of any suspicious lumps or palpable nodules requires further investigation. Usually an X-ray and a few lab tests are all that are needed to rule out some underlying systemic (disease) cause of the problem.

Knowing the specific signs and symptoms for each of the other conditions that can cause sciatica can help the examiner sort out what is and what is not piriformis condition. Sometimes it isn’t until the therapist tries a treatment approach that it becomes clear what is the problem. When physiotherapy doesn’t help, a series of BOTOX injections might be advised. This treatment technique has been supported by recent scientific studies. Physiotherapy combined with injections has been shown to be the most effective so far.

In summary, the authors looked for evidence of the highest level to help form clinical judgment, diagnostic strategies, and effective treatment options for piriformis syndrome. The goal is to help therapists get on the same page and treat piriformis syndrome in the same way across the country no matter where a patient lives. Most of the evidence available to date is moderately low in quality. More studies on this topic are needed to identify the best diagnostic test or tests and then the best evidence-based way to treat the problem.

Arthur Hulbert, PT, DPT, and Gail D. Deyle PT, PhD. Differential Diagnosis and Conservative Treatment for Piriformis Syndrome: A Review of the Literature. In Current Orthopaedic Practice. May/June 2009. Vol. 20. No. 3. Pp. 313-319.

Sciatica and Radicular (Nerve Related) Back and Leg Pain

Do you have lower back or buttock pain that runs down into one thigh or below the knee into the leg? If so, your doctor may diagnose your symptoms as sciatica—a term doctors use to describe compression of the sciatic nerve.

Sensations or unusual feelings may include numbness, tingling, pins and needles, and sometimes pain is described as electric-shock-like. Depending upon the individual nerve that is affected, pain can radiate only into the buttocks or all the way down to the foot. A common cause of sciatica and nerve compression is a lumbar disc herniation or bone spur that presses on a spinal nerve in the low back.

Sciatica pain radiates along the sciatic nerve, usually from the low back, down the buttocks, into the thigh and leg. One hallmark of classic sciatica is the pain and symptoms are felt below the knee and sometimes into the foot and great toe. Usually, sciatica only affects one side of the lower body.

Sciatica symptoms include low back and leg pain that may be described as burning or electric-shock-like. Photo Source: 123RF.com.

What Is Radicular Pain?

Radicular pain or radiculopathy are other terms your doctor may use when discussing sciatica. A radiculopathy is pain and/or adverse sensation that travels along a nerve. When a spinal nerve root is compressed, pinched or injured, it may become inflamed. Lumbar (low back) conditions that may cause this type of problem are spinal stenosis, foraminal stenosis, or herniated disc.

Diagnosis of Nerve Pain

The doctor will ask you about your symptoms, such as:

• When the pain started

• Where you feel the pain

• Activities that reduce or worsen pain and symptoms

• Whether the pain goes all the way down your leg or stops at the knee

• Is there weakness or tingling in your legs and/or feet?

• How severe your pain is, on a scale of 1 to 10 (10 is the worst pain imaginable)

The doctor may perform a straight-leg raise test to see if you have an inflamed nerve. You lie on your back while the doctor lifts each leg. If lifting a leg causes sciatic-like pain and sensations, you may have a bulging or ruptured disc.

The doctor may ask you to walk as you normally do, then on your heels and, next, your toes. This helps the doctor to check your balance and aspects of lower-body strength. Compression of the nerve can cause muscle weakness in the foot, which will be revealed by these tests.

During your exam, your doctor will:

• Look at your posture and range of motion

• Note any movement that causes pain

• Examine the curvature and alignment of your spine

• Feel for muscle spasm

• Check your sensation

• Test your reflexes and muscle strength

Your doctor may order a plain X-ray, CT scan or MRI. The CT scan or MRI provides the doctor with many snapshots of your spine, and can help confirm a suspected diagnosis. The findings of an imaging test are compared to the information the doctor gathers during the taking of your medical history, and physical and neurological examination results. An accurate diagnosis is one of the first steps in determining the best treatment options.

Other Causes of Nerve Pain

Only your doctor can tell for sure if your symptoms are sciatica. There are many other structures in the spine that can cause similar types of pain. For instance, the joint between the pelvic and sacrum (sacroiliac joint, or SI joint), the lowest part of the spine, can cause pain in the buttock.

You may also feel sciatica-like pain if you sprain a low back facet joint, which are the connecting joints in the back part of the spine. A tear in a disc can cause pain down into the leg. The hip joint can occasionally cause pain in the thigh.

Sciatica Treatment

Sciatica usually can be treated non-surgically with brief (24 to 48 hour) bed rest and pain relievers such as ibuprofen or acetaminophen. In some cases, the doctor may prescribe medication that relieves nerve pain, such as gabapentin. In most cases, patients with sciatica feel better over time, usually within a few weeks. If pain persists, steroid injections might be discussed.

Muscle spasms, which may accompany sciatic symptoms, may be treated with heat or cold. Your doctor may tell you to take short walks, and may prescribe physical therapy. Once you recover, your doctor may give you exercises to strengthen your back.

Notes: This article was originally published December 1, 2015 and most recently updated October 27, 2022.

Sciatica. Merck Manual. Reviewed March 2013. http://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/neck-and-back-pain/sciatica. Accessed July 2, 2019.

Sciatica. American Academy of Orthopedic Surgeons. Reviewed December 2013. http://orthoinfo.aaos.org/topic.cfm?topic=A00351. Accessed July 2, 2019.

Our Review Process

Drawing pain in the thigh, buttock and groin

Drawing pain in the thigh, buttock or groin is a common symptom that makes people immediately seek treatment from doctors of various specialties. Most people at least once in their lives have experienced such complaints. Self-administration of medications, application of anesthetic ointments, warming up can aggravate the development and manifestation of pain without an accurate diagnosis.

Let’s try to understand the causes, possible diseases associated with the manifestation of such symptoms, as well as methods of diagnosis and treatment.

The main causes of pulling pain in the thigh, buttock or groin

The search for the starting point of such a complaint often causes difficulties in differential diagnosis, since the causes of unpleasant sensations in these areas may be the result of a number of pathological conditions of the human musculoskeletal system. There are everyday causes (lifestyle, postures at work), acute diseases (traumas, exacerbations of chronic conditions), functional deviations in the work of the muscular corset.

Among the provocateurs of this pain syndrome, it should be noted:

– excessive physical activity associated with labor activity

– “sedentary” work;

– overweight problems;

– the period of bearing a child.

Conditions and diseases of the musculoskeletal system, the symptom of which may be drawing pain in the lower limb.

1. Lesions of the lumbosacral spine.

Degenerative-dystrophic processes in the spine often become the main cause of pain in the thigh and buttock. This is due to the pathological cascade of changes in the state of the intervertebral discs, intervertebral joints of the ligamentous-muscular corset. With the progression of intervertebral protrusion or hernia, compression and irritation of the nerves may occur, resulting in pain symptoms. Depending on the level of this influence, the localization of the problem will also change.

2. Arthropathy of the hip joint

Among the lesions of the hip joints, coxarthrosis should be ranked first. The prevalence of this pathology, according to scientific literature, reaches 18% in the group of diseases of the musculoskeletal system. Clinical manifestations of coxarthrosis, namely, limited mobility in the joint, sparing of the leg when walking, pain when probing soft tissues, muscle spasm can cause pain both in the back and in the hip area. Second defeat

3. Femoral neuropathy

Femoral neuropathy is a fairly common mononeuropathy of the lower extremities. There are several areas in which the anatomical and topographic features of the femoral nerve predispose it to an increased risk of compression or injury – in the region of the iliopsoas muscle, under the inguinal ligament, in the region of Gunther’s canal and when exiting it. Depending on the level of the lesion, the clinical manifestations of femoral neuropathy vary significantly.

4. Physical injuries of the thigh area

Any traumatic impact on the muscle structures of the lower limb gives a range of pain symptoms. Bruises, sprains and overstrain of the musculoskeletal system, the consequences of femoral fractures should be considered as a possible cause of pain. Even remote manifestations are often the result of trauma.

5. Trochanterite

This is inflammation of the upper point of the femur, called the trochanter, to which tendons and muscle fibers are attached. Given the inflammatory nature of tronchateritis, this disease is often mistaken for arthrosis. This condition is characterized by pain during verticalization, movement. The anterior-lateral surface of the thighs is most often affected. Unlike coxarthrosis, movement in the joint is not objectively limited.

6. Myofascial pain syndromes

Musculoskeletal disorders are also one of the factors of pain in the thigh and buttocks. Most clearly, such a pathology is reflected by myofascial pain syndromes, characterized by the development of muscle dysfunction and the formation of local painful seals in the muscle tissue. The most common of these syndromes are piriformis syndrome and iliac-tibial tract syndrome.

Piriformis syndrome is a condition that is particularly associated with pain in the buttock and/or thigh. In some articles this syndrome is defined as peripheral neuritis of the branches of the sciatic nerve caused by non-physiological overexertion of the piriformis muscle. Women with CGM are diagnosed more often than men (ratio is 6:1)

(connective tissue that covers all the muscles in your body) connective tissue that runs from the top of the pelvis down the outer thigh, crosses the outside of the knee, and attaches to the very top of the tibia. This anatomical structure serves as a link between the main muscles of the pelvis and the knee. The main function of this tract during running is to stabilize the knee during the impact of the foot on the ground. The syndrome of the iliac-tibial tract most often develops against the background of its damage. The pain is localized in the area of ​​the outer part of the knee or just above it, although it can extend up to the top of the femur.

7. Joint dysfunction and flat feet.

Tracing the direct muscular-fascial relationship of the distal and proximal parts of the lower limb, it is necessary to take into account pathological changes in the ankle joints and feet. Regular physical overload, as well as deformation of the anatomical structure of the feet, give ascending causes of the development of pain symptoms in the upper legs, in the hip joint, ligaments and muscles. The scientifically proven myofascial kinematic chain with a high frequency leads to the development of pain in the area of ​​the previously mentioned regions. However, such a clinical picture does not always have organic lesions in the joints, muscles or bone and ligamentous elements. Localization of pain sensations may vary depending on the violation in a particular biomechanical motor chain.

Diseases and pathological conditions not associated with damage to the musculoskeletal system and capable of causing similar pain

– Diseases of an infectious or parasitic nature, accompanied by fever, severe intoxication, damage to the vascular membranes of the brain and spinal cord (bacterial or viral infections, tick-borne encephalitis, borreliosis, botulism, trichinosis)

– Damage to the vascular and lymphatic bed of the pelvic region and lower extremities (varicose veins, atherosclerotic changes in the walls of blood vessels, lymphostasis)

– Conditions characterized by deficiency of vitamins and microelements formations in muscle tissues and connective tissues (rhabdomyosarcomas, leiomyosarcomas,

– Side effects of drugs (glucocorticosteroids, hypolipidemic drugs)

– Endocrinological diseases (diabetes mellitus)

– Physiological pain symptoms during pregnancy due to postural restructuring of the vertical axis of the body

– Ecomb syndrome (restless legs syndrome)

– Autoimmune diseases

900 07 Diagnosis

Correct diagnosis – the key to effective and high-quality treatment. Therefore, there is a certain examination algorithm, the volume of which can be determined by the doctor. The diagnostic path of a patient is built from the following steps:

1. Consultative examination and history taking.

2.Manual-muscle testing, assessment of motor stereotypes, detection of violations of the biomechanical chain of the musculoskeletal system.

3.Performance by the patient of specific tests and samples

4.Passage of additional laboratory and instrumental methods of research: general and biochemical blood tests, laboratory tests for specific markers, radiography, ultrasound, Electroneuromyography, MRI, MSCT.

5. Consultation of doctors of related specialties for verification of differential diagnosis.

This amount of diagnostics allows you to accurately determine the pathology and the cause that caused pain, since pain in the thigh, buttocks, groin can have different etiological factors. A well-designed diagnostic strategy allows the doctor to prescribe the necessary range of therapeutic measures in a short time.

Treatment

Any physical discomfort that changes the quality of life and movement will force a person to look for ways to solve and get rid of the disease. Often the lack of clinical thinking and trust in the media have a negative impact on the development and progression of the pain syndrome. Prolonged refusal to visit a doctor, self-administration of medications and various procedures can lead to chronicity and difficulty in conservative treatment, turning to radical, surgical methods of treatment, followed by loss of functions and limitations.

At the Freedom of Movement Medical Center, an experienced team of qualified doctors will help you accurately diagnose and create an individual set of treatment procedures for achieving recovery. The staged reception of doctors allows the patient to ensure the smoothness and softness of the impact of therapeutic instruments.

Stage 1 is the initial appointment and diagnostics.

Stage 2 – treatment.

After the final diagnosis is made, a treatment plan is formed, which may include the following procedures:

– manual therapy

– osteopathy

– medical massage

– acupuncture

– physiotherapy

– medical therapy (therapeutic intraarticular and paravertebral injections, P RP-therapy, ACF-therapy, droppers)

Stage 3 – stabilization of the result

After achieving a stable improvement in the previously impaired function, reducing the pain syndrome, the patient proceeds to the stabilization phase. The basis of such consolidation of the result is a complex of means of therapeutic physical culture (LFK). The goals of exercise therapy are to strengthen the muscular corset, improve balance and coordination of movements, increase the range of motion in the joints, develop the flexibility and elasticity of the muscular-ligamentous apparatus.

Returning to possible provocateurs of the pain syndrome, in particular pain in the buttocks, thighs or groin, the patient is clearly and easily explained the need to form healthy habits and an optimal lifestyle:

– organization of a comfortable workplace

– position hygiene at night

– healthy balanced nutrition

– preventive examinations

– procedures supporting the result of treatment

– performing home individual exercises.

Characteristics of sciatica pain

Sciatica is also called sciatic neuralgia. This nerve is the longest in our body. There are two of them. They start at the level of the lumbar spine, continue at the level of the buttocks, the back of the leg, and separate behind the knee. As a result of damage to the sciatic nerve, sensory and motor disorders can appear: difficulty walking and reduced sensation in the leg. The main sign of pinching or inflammation of the sciatic nerve is intense pain. Its nature depends on the location of the pathology. Pain is varied. Usually affects one side. Moreover, in women – the right, in men – mainly the left.

The nature of sciatica pain

It is often described as dull, throbbing, burning, or stabbing like an electric shock. Sensation varies and can manifest itself differently in one person. For some people, it feels like a debilitating intense burning sensation, while for others, a sharp tingling or intense pain passes quickly and occurs from time to time. Each case is different and each sensation is unique for each patient. These painful symptoms often begin suddenly, “out of the blue,” but sometimes they can be provoked by a sharp turn or lifting of weight. It can become unbearable with exertion, coughing, standing or sitting for long periods of time. As a rule, sciatica increases with movement and decreases during rest. But in the case when sciatica is caused by an infection or tumor, the pain appears, paradoxically, at night or when the patient is motionless. In addition, symptoms worsen and may be associated with fever.

Sciatica pain localization

The pain usually appears in the buttock area and descends in a burning strip to the thigh in front and side, then down the back of the leg, reaching the foot and toes. Sometimes the pain stops in the knee. With inflammation of the piriformis muscle, burning or pulling pains in the buttock radiate to the middle of the back of the thigh, they usually do not go further. Sometimes there is pain in the lumbar spine, which increases with prolonged sitting. Lower back pain may be present at the same time as leg pain, but usually the pain in the legs is much worse than in the lower back. Complaints of back pain may not bother the patient.

Typical manifestations of pain in sciatica

The combination of the following pain symptoms is the most common:

• pain usually occurs on one side of the buttocks or leg, rarely on both sides;
• pain descends from top to bottom;
• the pain has a characteristic trajectory – occurs in the lower back or buttocks and continues along the path of the sciatic nerve along the back of the thigh and lower calf and foot;
• the pain disappears when the person lies down or walks, but worse when he stands or sits;
• the pain is usually described as sharp or burning rather than monotonous.
• intense flash of pain in one limb, it becomes impossible to lean on it, this makes it difficult not only to get up, but also to walk;
• numbness in the fingers of the lower extremities;
• pain in the lower back (if present) is usually not as severe as in the extremities;
• the pain is most intense in the morning and after a long rest;
• complaints may be aggravated during sudden movements, such as sneezing, coughing, when changing position, for example, when moving from a sitting to standing position, when turning, when trying to stand on tiptoes.

Some symptoms are unique depending on the underlying cause of sciatica. For example, bending the body backwards or walking short distances often causes symptoms when spinal stenosis is the cause. Leaning forward can cause pain if the cause is a bulge in the lumbar spine. If sciatica is due to a herniated disc, the pain is often worsened by coughing, sneezing, or straining (during a bowel movement), or movement. In severe cases, urination and defecation are disturbed. If inflammation is the cause of the sciatic nerve, the pain often worsens at night.

How long does the pain last?

How long the sciatic pain lasts depends on how badly the nerve is damaged. Sometimes the symptoms disappear after a few days, sometimes they last longer or come back again and again.

Conclusion

Illness with sciatica is exhausting. Especially the patient suffers if the disease has passed into the chronic stage. Pain significantly reduces the quality of life, the patient cannot make elementary movements, sleep is disturbed.