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SCIATICA / PIRIFORMIS SYNDROME

Sciatica
image: www.orthopod.com

Sciatica is a condition where the bony structure of the lumbar spine at L4 and down to the sacral bones at S1 have inflamed the nerve routes affecting the sciatic nerve path as it exits the buttocks. Common causes of Sciatica are:

  • Stenosis
  • Osteopathic
  • Spinal Fusion
  • Bursitis
  • Osteoporosis
  • Facet Disruption
  • Herniated Discs

Piriformis Syndrome occurs when the sciatic nerve is compressed causing pain, tingling, or numbness in the buttocks and down the leg. Piriformis Syndrome occurs when there is sciatica present without a clear spinal cause.

Yoga practices with weak and/or tight low back muscles may aggravate the condition in straight-legged forward bends.

 

Inaction gluteal muscles may cause the syndrome to develop. A major cause for inaction gluteals is overactive hip flexors. [Psoas Major, Iliacus, and Rectus Femorus]

This imbalance occurs when the hip flexors are trained and become too short and tight; as in when someone sits with hips flexed all day at work. This deprives the gluteals of activation and the hamstrings, adductors, and piriformis muscles have to perform extra roles they were not designed to do. The result is swelling of the piriformis that produces sciatica symptoms.

Runners, cyclists, and athletes engaging in forward-moving activity are susceptible to piriformis syndrome if they do not engage in lateral stretching and strengthening exercises.

Weak outer thighs and hip muscles combined with tight inner thigh muscles can cause the piriformis muscle to shorten and severely contract.

Another cause for piriformis syndrome may be stiffness of the sacroiliac joint. This changes the walking gait and can result in sheering the origin of the piriformis causing malfunction and low back pain.

Over pronation of the foot causes the knee to turn medially causing the piriformis to activate the stop the knee from over rotating, resulting in overuse of the piriformis muscle, thus leading to piriformis syndrome.

Lastly, the most frequently associated cause is a falling injury.

Treatment generally begins with stretching exercises and massage and avoidance of contributing activities. Physical therapy, stretching techniques, and strengthening core muscles reduce strain on the piriformis. Check with your doctor who may require an MRI to accurately diagnose sciatica and piriformis syndrome. Depending on your diagnosis, your doctor may recommend alternating ice and heat, steroid injections, corrective shoes, or anti-inflammatory drugs. Alternative therapies may be indicated, such as acupuncture and ultrasound.
The following yoga poses will help release the hip flexors. A regular backbend practice in the presence of a knowledgeable teacher who can check your alignment may alleviate your pain.
Plank
Happy baby
Tripod
up
Table Top
Bridge
Happy Baby
Chair Backbend
Eastern Plank
Tabletop
Half Camel
Crow
Fish
Puppy Dog
Pigeon
Hero on block
Half Camel
Hero
Forward Bend Soft Knee
Camel
Pigeon
Hero on a Block
Cobbler
Locust crocodile
Lord of Fish
Cobbler
Locust
Thunderbolt
Lord of Fish
Spinal Twist