How To Tell If Your Sciatica Is Actually Piriformis Syndrome
Is your sciatica acting up, or do you have piriformis syndrome? You may be surprised at just how much these conditions get confused with one another. If you have chronic pain that radiates through your buttocks and lower back, it could mean that youre living with piriformis syndrome. Its not uncommon for these two conditions to be mistaken for each other. However, learning if you have piriformis syndrome can help you get on the right path for recovery. Lets take a closer look at understanding the difference between these conditions and what you can do about it.
Why Is My Sciatica Pain Getting Worse
The likely cause of your sciatica pain worsening is due to inactivity. Lack of exercise and physical activity can make sciatica worse in the long term.
If you are sitting down too much, the sciatic nerve, which runs from your lower back to your feet, gets irritated from the pressure of spinal discs. The nerve ends up getting squashed between the discs and bones. Behind the disc, there is also a joint which can become stiff and painful to move and the muscles overlying that also become stiff. Usually, when you move, the joint opens and offloads the nerve, but being too inactive makes that joint less mobile and compresses the sciatic nerve.
People with sciatica usually avoid activity because of the pain which only causes the muscles and joint to become stiffer and tighter. Consequently, the pain gets worse.
Disc enlargement is another cause of sciatica pain. The nerves in the spine normally have enough space to slide up and down the spine, but if a disc bulges or enlarges, it can put pressure on the nerve and increase your lower limb pain.
Stretching And Strengthening Exercises
Exercise programs can help recovery and may reduce the frequency and length of recurrent episodes of back pain. It may help to see a physiotherapist, who can design an individual exercise programme for you that involves strengthening and stabilisation of the muscles that support the spine, stretching and also aerobic exercise.
Exercises such as Pilates, which correct poor muscle tone and posture and improve core strength and stability of the spine, can help improve back pain and also help to prevent future episodes.
Gentle passive stretching exercises may help to relieve compression in the spine. Specific floor stretches can be helpful.
Some yoga poses may also help relieve sciatica pain. However, note that suitable stretches for sciatica differ depending on the cause of the sciatica. For example, there are specific stretching exercises which are almost always necessary to relieve piriformis syndrome and these differ from the stretches to ease sciatica caused by spinal stenosis.
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Using Shoes With High Heels And Arent Adequately Cushioned
Wearing high-heeled shoes shifts your body weight and the center of gravity, forcing you to hunch forward at the hips. On the other hand, footwear without cushioned insoles contributes to transferring the impact of steps to the hips or back. These events can lead to stretching of the hip and the knee muscles alongside the sciatic nerve, resulting in irritation and compression.
Exercises That Help Reduce Sciatic Nerve Pain
Theres nothing more painful and uncomfortable than a pinched sciatic nerve. People with this condition experience mild to moderate pain in their lower backs, buttocks, legs, and feet. When the pain becomes severe, they may even find it almost impossible to move or walk. Experts highly recommend stretching as one of the best exercises for sciatic nerve pain.
What exactly is sciatica, and how do you know if you have it? Keep reading for everything you need to know about it, the best stretches for sciatic nerve pain, and some fast facts about sciatica.
WHAT IS SCIATICA AND ITS SYMPTOMS?
Sciatica happens when the sciatic nerve gets irritated and causesa sharp, shooting, or burning pain. This sciatic nerve is the longest and thickest nerve in your body, running through your lower back, hips, buttocks, and legs. It can also branch out into other nerves in the feet.
You will begin to notice sciatic nerve pain when there is pressure or damage to the sciatic nerve. This can happen because of underlying conditions such as a slipped herniated disk, tumors, or a pelvic injury.However, not all specific events can lead to sciatica. Sometimes, certain jobs can lead to sciatic nerve pain.
Some people may also notice numbing sensations and or weak legs. Its important to note if you have pain that gets worse when you move. In rare cases, sciatica can also causecauda equina syndrome, which is the inability to control your bowels and bladder.
WHO IS MOST AT RISK OF GETTING SCIATICA?
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Is Heat Or Cold Better For Sciatica Pain
For acute episodes, cold packs or ice can reduce inflammation, alleviating some of the pain. Cold packs are best applied for the first two to seven days of an acute episode, according to Spine-Health.com. Once the acute pain has subsided, heat packs can be used to increase the flow of oxygen to the area.
Signs You Might Need Surgery
Most people with sciatica don’t need surgery. But your doctor may suggest it if you have trouble walking, lose control of your bladder or bowels, or your pain gets worse and other treatments don’t help. The best procedure depends on what’s causing your symptoms. The most common one removes the part of your herniated disk that’s pressing on the sciatic nerve.
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Pain Relief For Sciatica
Pain relievers can be used to control sciatica pain so that you can stay active, which in most cases will help you get better faster.
Non-steroidal anti-inflammatory drugs , such as ibuprofen , are often recommended for sciatica and can reduce pain as well as inflammation. They should be taken at the lowest dose that is effective for the shortest possible time. However, there are side effects associated with these medicines, including an increased risk of peptic ulcers, heart conditions and kidney problems and NSAIDs are not suitable for some people. The risk of side effects is reduced when NSAIDs are given topically .
Paracetamol may be recommended for people who are not able to take NSAIDs. While paracetamol does not reduce inflammation, it may reduce back pain in the short-term and any reduction in pain that allows you to resume activity will be beneficial.
Sitting With Some Lower Back Support
Giving the lower back some support, whether it is by using a lumbar roll cushion or sitting in a chair with built-in lumbar support, can help provide your muscles with enough help to let them relax a little more to take enough pressure off of the sciatic nerve so that you can experience some relief.
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Using Cold And Heat To Alleviate Sciatica Pain
When you first start experiencing sciatica pain, applying a cold pack can provide a lot of relief. Wrap a cold pack or a bag of frozen peas in a clean towel, and apply it to the painful area a few times a day for up to 20 minutes each time.
If your sciatica is still bothering you after a few days, then it can be helpful to try heat instead. Apply a heat lamp on the lowest setting, a hot pack, or a heating pad to the painful area.
If your pain persists, try alternating between cold packs and hot packs.
Sciatica Vs Piriformis Syndrome
First, its important to know that sciatic and piriformis syndrome has many of the same symptoms. Thats why its so easy to mistake them for each other. However, the primary symptoms of piriformis syndrome include:
- Pain in the buttocks that is worse when sitting
- Pain in the opposite sacroiliac joint
- Pain when sitting or standing for 20 minutes
- Iain when sitting or squatting down
- Pain that is felt from the sacrum down the back of the thigh that usually stops just above the knee
- Pain that lessens with movement
- Numbness of the foot
The main thing to remember is that the underlying causes of these conditions are different. Sciatic is a series of symptoms that are caused by another issue, such as a herniated disc. Piriformis syndrome occurs when your sciatic nerve is irritated or compressed by your piriformis muscle, deep in your pelvis.
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Note: Piriformis Syndrome Feels Like Sciatica But It Isnt
There is a muscle where the thigh bone meets the buttocks called the piriformis. When this muscle becomes tight, it can irritate the sciatic nerve, causing similar pain, but this isnt truly sciatica, where the nerve is compressed.
Why does this matter? The treatments for piriformis syndrome and sciatica are different. Your chiropractor will be able to diagnose what the root cause is and whether or not you have sciatica.
Guide To Sciatica Exercises The 9 Best For Sciatica Pain Relief
It is no secret that a huge part of my approach as a sciatica specialist is providing people with the right sciatica exercises! If the exercises I give are appropriate, they can lead to truly significant sciatica pain relief.
However, its not always easy to choose the right sciatica exercises that you should be doing.
In this article, Ive picked 9 of my most effective sciatica relief exercises to show you today. Youll find pictures of sciatica exercises as well as videos for each. Ive also included a handy guide for choosing which sciatica exercises are right for you. Youll find a guide to the number of repetitions and sets you should be doing for each exercise below the pictures.
Of course, not all of these exercises will be right for everyone and choosing the right sciatica exercises is often a game of trial and error.
As always, I recommend to everyone that these exercises should be pain-free at all times. You can read about why I tell everyone this by clicking here. If you find one of the following exercises painful, simply stop and choose another instead.
First, its important to ask the question Should I be doing sciatica exercises right now? Or would rest be better?
Ive answered this question in the video below:
So, once youve watched the video above, lets have a look at some of my most effective sciatica exercises for pain relief:
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What Causes Sciatica To Flare Up
Sciatica triggers can be different for each person. Some people also find that they have multiple causes of flare-ups. Knowing what triggers sciatic nerve pain is crucial because it will help a lot in preventing and managing them. For that reason, you should be aware of any triggers that you may have. If you can identify what causes sciatica to flare up, youll know what you can do to avoid them.
Here are the ten triggers that may be causing your sciatica to flare up that you need to watch out for:
How Is Sciatica Treated
The goal of treatment is to decrease your pain and increase your mobility. Depending on the cause, many cases of sciatica go away over time with some simple self-care treatments.
Self-care treatments include:
- Appling ice and/or hot packs: First, use ice packs to reduce pain and swelling. Apply ice packs or bag of frozen vegetables wrapped in a towel to the affected area. Apply for 20 minutes, several times a day. Switch to a hot pack or a heating pad after the first several days. Apply for 20 minutes at a time. If youre still in pain, switch between hot and cold packs whichever best relieves your discomfort.
- Taking over-the-counter medicines: Take medicines to reduce pain, inflammation and swelling. The many common over-the-counter medicines in this category, called non-steroidal anti-inflammatory drugs , include aspirin, ibuprofen and naproxen . Be watchful if you choose to take aspirin. Aspirin can cause ulcers and bleeding in some people. If youre unable to take NSAIDS, acetaminophen may be taken instead.
- Performing gentle stretches: Learn proper stretches from an instructor with experience with low back pain. Work up to other general strengthening, core muscle strengthening and aerobic exercises.
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The Best Stretches And Exercises For Sciatica
As handy as it would be for certain stretches and sciatica exercises to relieving sciatica across the board, the reality is that everyone experiences sciatica differently, and that what helps one person might actually hurt another.
Listen to your body, and dont try to push through anything that doesnt feel right for you, Jones says. Exercising through pain will result in worsening symptoms. Itll also likely throw off your form, which will raise your risk of exercise-related injury.
Rather than pushing through, its important to figure out what motions improve your pain and do more of that, and what motions worsen your pain, so you can temporarily avoid those, he says.
Over time, after your symptoms subside from doing sciatica exercises, you may be able to gradually add back in those previously irksome movements without pain.
To aid your quest for sciatic nerve pain relief, we asked Jones for his favorite stretches and exercises that most commonly ease sciatica. All or some may work for you. Try them out, performing any winners at least twice per week and as often as every day.
As always, safety is key with sciatica exercises. If you have a chronic condition, an injury, or balance issues, talk to your doctor about how you can exercise safely as we do not provide medical advice.
Randomised Controlled Trials Not Yet Included In Systematic Reviews
Two additional randomised controlled trials have been published comparing disc surgery with conservative treatment. One trial compared microdiscectomy with conservative treatment in patients who had had sciatica for six to 12 weeks. Overall, no significant differences were found for leg pain, back pain, and subjective disability over two years of follow-up. Leg pain, however, seemed to initially improve more rapidly in patients in the discectomy group. The large spine patient outcomes research trial and related observational cohort study was carried out in the United States. Patients with sciatica for at least six weeks and confirmed disc herniation were invited to participate in either a randomised trial or an observational cohort study. Patients in the trial were randomised to disc surgery or to conservative care. Patients in the cohort study received disc surgery or conservative care based on their preference. In the randomised trial both treatment groups improved substantially over two years for all primary and secondary outcome measures. Small differences were found in favour of the surgery group, but these were not statistically significant for the primary outcome measures. Only 50% of the patients randomised to surgery received surgery within three months of inclusion compared with 30% randomised to conservative care. After two years of follow-up 45% of patients in the conservative care group underwent surgery compared with 60% in the surgery group.
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Best Pain Relief For Sciatica
Sciatica is something that affects millions of men and women worldwide. Though it is obviously not life-threatening, it can often be one of the most painful conditions ever when left untreated, and sufferers are notoriously dissatisfied with how it is handled medically. Due to the nature of the condition, it is something that often worsens dramatically when left untreated and can be gut-wrenching to deal with especially when mishandled. Sciatica not only puts a strain on the person suffering from the illness, but on the whole family as it forces loved ones to care for the sufferer, making it one of the worst physical conditions to deal with.
All Fours Opposite Arm And Leg Extensions
Purpose: To strengthen your abdominal muscles, low back and stabilize those areas.
- Begin by positioning yourself on all fours.
- Contract your abdominal muscles to help keep your back flat and straight.
- Raise one leg upward behind you and straighten in outward.
- Hold for 3 to 5 seconds.
- Repeat the movement on your opposite side.
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When you can perform this exercise 10 times with tolerable pain, you can add arm movement with each leg extension:
- Extend the arm upward and outward in front of your body.
- Hold for 3 to 5 seconds.
- Repeat on the opposite side.
-
- Perform this exercise up to 10 times.
Leg and arm opposite stretch can help strengthen your abdominal muscles, low back and stabilize those areas. Photo Source: 123RF.com.
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Oral Steroids May Reduce Sciatic Nerve Root Inflammation
Oral steroids, such as methylprednisolone and prednisone help reduce inflammation. Doctors may prescribe oral steroids to treat acute sciatica due to an inflamed spinal nerve root.5 Steroids are generally prescribed for short bursts of therapy.
For chronic sciatica, doctors may prescribe antiepileptic and antidepressant medications, which have shown to improve nerve pain. To reduce the risk of potential side effects, treatment is typically started with a low dose and increased gradually to determine the lowest effective dose.2,6
Sciatica typically resolves in 4 to 6 weeks without long term complications.7 Medications are an effective option to reduce acute sciatica pain and are usually recommended for short term use. Your doctor can help select which drug is appropriate for your specific underlying cause of sciatica, age, and general health and tolerance. For long term pain relief and to prevent recurrences, talk to your doctor about more specific treatments for the cause of your pain, such as physical therapy, manual manipulation, and massage therapy.
Read more about Sciatica Treatment
How Do I Get My Sciatic Nerve To Stop Hurting
To improve your sciatica pain, it is important to first find the true root cause of your pain. Sciatica may develop over time as the result of muscle imbalances around the pelvis and lumbar spine. This impacts the alignment of the structures and function of the muscles in these areas, ultimately compressing on the sciatic nerve and causing pain. Using a combination of muscle release and corrective stretching and strengthening exercises, you may be able to improve the alignment of your body and the functioning of the supporting muscles, addressing that root cause to improve your sciatic pain.
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