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Sciatica

Sciatic_N_and_Piriformis_M_Close_Up.jpg

Symptoms

  • Compression of the Sciatic Nerve

  • Low Back Pain

  • Pain referring into the buttocks

  • Pain referring into the posterior leg or calf

  • Numbness or tingling in the posterior leg or calf

Cause

  • Biomechanical dysfunction of the pelvis, usually the Sacroiliac Joint

  • Having a variant formation of the Piriformis muscle in relation to the sciatic nerve (eg bifurcated piriformis)

  • Direct trauma including a fall or a sports injury

  • Prolonged sitting

  • A sudden increase in activity

  • The piriformis muscle becomes very tight or spasms compressing the Sciatic Nerve as it exits the pelvis through the Sciatic Notch

Diagnosis

  • History related to the onset of pain

  • Palpation of the piriformis muscle spasm

  • Pressure on the piriformis muscle reproducing the symptoms associated with piriformis syndrome

  • Specific orthopedic tests to determine involvement of the SI Joints

  • Ruling out causes of similar symptoms (eg lumbar HNP)

Treatment

  • Chiropractic manipulation to restore proper biomechanics

  • Passive therapies to reduce pain and inflammation

  • Soft tissue work to relax the piriformis muscle and loosen adhesions related to the sciatic nerve

  • Stretching to reduce tension of the piriformis muscle and exercises to restore proper strength and stability to the area