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Sciatica & Low Back Pain - How the Piriformis Muscle Causes Pain

Jul 6, 2008
Although Low Back Pain & Sciatica are two separate conditions, with the former relating to pain felt in and around the Lower Back region and the latter describing pain wihch travels down the leg, they share a lot of similarities with regards to their cause. One of several common causes between them is a tight Piriformis muscle.

Passing from the Sacrum to the outside of your hip, the Piriformis muscle is situated deep within your buttock. The Sciatic Nerve is also present in this region and it actually passes either through or just underneath the Piriformis muscle.

With the Sciatic nerve passing in such close proximity to the Piriformis muscle, it should come as no surprise that, if this muscle is tight, it will place increased stress upon the Sciatic Nerve, resulting in pain. As far as Low Back Pain is concerned, the reasons for pain are completely differrent. With the Piriformis muscle attatching to the Sacrum, if this muscle is tight, it will be continuously 'pulling' upon this bone.

This continuous stress being placed upon the Sacrum, by a tight Piriformis muscle, actually has an influence upon the Sacro-Iliac Joint. This joint is situated in the Lower Back region and is made up of the Sacrum and the Ilia (the Ilia being a specific part of the pelvis which forms the other half of this joint). Therefore, pain may well occur due to the repeated stresses across this joint.

The Lumbar Spine is therefore not the only potential source of pain for this region, it may be the Sacro-Iliac Joint which is responsible instead or as well as it. Typically, this pain is felt a little lower than 'normal' Low Back Pain, although this is not always the case. In addition to this, just above the buttock area there is a little dimple (for most, but not everyone) either side of the mid-line. If it feels as if your pain is coming form here, it may be the Sacro-Iliac Joint which is responsible for your pain.

Aggravation to the Sciatic Nerve, anywhere along its length, can result in Sciatica. However, if a tight Piriformis muscle is the cause of your pain, the chances are the 'focus' of your pain is going to begin in the buttock region. If this is the case, the Piriformis muscle will need to be stretched.

It would be too difficult, and probably confusing, to try and describe a Piriformis stretch without the use of a diagram. Therefore, I have placed a link below which will show you how to stretch a tight Piriformis muscle.

There are alternatives to stretching, or maybe I should say additions to stretching, which are very effective at making this muscle more supple. One way is by using a small ball, such as a tennis ball:

Lie yourself on your back with your knees bent. Place the ball approximately in the middle of buttock on the side which needs to be massaged (this is approximately where the Piriformis muscle is). From there, gently 'roll' the ball by moving / rotating your buttock, so that the ball gently massages the area underneath.

This self massage exercise can be an excellent way of loosening up the Piriformis Muscle. However be careful, as it may also aggravate your Sciatica if the pain is still quite sensitive. This is because not only will you be massaging the Piriformis muscle, but also the Sciatic Nerve as it passes through or underneath it. Consequently, it may stir your pain up a little.

If it does, this is nothing to worry about. However, it is your body's way of telling you it is not ready for that kind of treatment yet. Have a rest for a day or two and then try again, only being a little gentler next time!

If a tight Piriformis muscle is contributing to your Low Back Pain or Sciatica, then gently stretching and massaging this muscle will help alleviate your pain.
About the Author
Paul Boxcer is a BSc (Hons) Physiotherapist.
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