If you’re suffering from lower back pain or an aching pain in the back of your thigh, it is very likely that you have a tight piriformis muscle that is aggravating the sciatic nerve.
In fact, the Journal of Neurosurgery: Spine estimated that an individual has a 40% chance of experiencing sciatica sometime in their life – that’s a pretty big chance!
Do I Have Sciatica?
Sciatica is defined as tenderness, numbing, weakness and/or pain anywhere along the sciatic nerve, typically showing up on only one side of the body. There are actually two sciatic nerves, one for each leg. They pass through layers of deep buttock muscles, and then through the deep muscles of the back of the thigh and then down towards the outer edge of your leg to your foot.
Sciatica flares up usually when someone is in the act of bending over, sitting (especially driving), running or even walking. It is characterized by one or more of the following symptoms (1):
– Constant pain in only one side of the buttock or leg (usually not in both legs)
– Pain that gets worse while sitting
– Leg pain that is described as burning, tingling, or searing (instead of a dull ache)
– A sharp pain that makes it difficult to stand up or walk
– Weakness, numbness, or difficulty moving the leg, foot and/or toes
– Pain that radiates down the leg and possibly into the foot and toes
– Foot drop: a condition where you cannot flex your ankles enough to walk on your heels
– Reduced reflexes in your Achilles tendon and knee
What Caused Your Sciatica?
When I was suffering from sciatica, it was triggered by bending too deep into a yoga pose where I hadn’t warmed up properly (and also wasn’t performing the pose properly and pushed myself much further than my body was capable). It took more than a year and a half for my sciatica to completely heal, and have been symptom-free for about 3 years.
I didn’t go to a doctors office, because I wasn’t experiencing any back pain, and only buttock/leg pain, but I did see an Osteopathic manual practitioner. The best cure for my sciatica was plenty of rest, very light stretching, massage, and time. Most medical doctors, when they hear about someone complaining of sciatic nerve pain, look for a herniated disk in the lumbar spine, which may be pressing on the sciatic nerve. If you are experiencing pain in your mid-lower back, and painful electric shocks down your sciatic nerve, it is important that you get your disks checked out by a doctor. Herniated disks are a bigger problem than dealing with just sciatic pain caused by something else.
Another common cause of sciatic nerve pain is a tight piriformis muscle, and more often than not, this is what most people are experiencing. In a 2005 study in the Journal of Neurosurgery: Spine, over 70% of sciatica cases are caused by the piriformis muscle.
The sciatic nerve passes underneath the piriformis muscle on its route to the posterior thigh. However, for a lot of people, the sciatic nerve can actually pass right through the muscle, leading to sciatica symptoms caused by a condition known as piriformis syndrome. If the piriformis is tight (which it often is), it will exert pressure on the sciatic nerve and push it against the tendons beneath it – resulting in excruciating pain.
Is It The Piriformis Causing The Issue?
You can tell if the piriformis muscle is causing issues with the sciatic nerve by using the following indicators (2):
– Pain and pins-and-needles sensation that runs down the outside of your calf to the space between the little and fourth toes.
– Difficulty walking on your heels or on your toes.
– Pain from sitting, which is often accompanied by a tingling sensation at the back of your thigh.
– Your toes may feel numb when standing, even if you have relief from pain when standing.
– Burning in the back of your thigh and calf down to your heel, with leg stiffness.
– Buttock and sciatic pain from exercising or sitting for long periods – this can come with or without numbness, weakness or tingling.
– Pain always gets worse when sitting down, even if you have minor pain when standing.
For me, my sciatic pain was very evident, as sitting was incredibly uncomfortable for me. I could never really sit properly or had to have my affected leg lifted so that no pressure was that side of my buttocks and thigh.
You can also do the F.A.I.R test (Flexed, Adducted, and Internally Rotated), where you lie on your side with the affected leg on top. Bend the top leg with the knee resting on the floor in front of you – is it painful? Or, if you try to lift your knee away from the floor against a small amount of resistance (like a lightweight), does it hurt? If you experience sharp pain in the hip while doing this, it is likely that the piriformis muscle is what’s causing sciatica.
As with all stretching routines, make sure you warm yourself up a little bit before doing them. Whether that’s doing some light dancing or a quick walk around your neighborhood for 10-15 minutes. Also, go slow into the stretches and be patient with your body. You likely will not be able to go very deep into these postures at first, but over time, your body will get better at it. Do not push yourself beyond your body’s own capabilities. Be gentle with yourself, and slowly go into each stretch.
Here are 7 stretches that will help release a tight piriformis muscle and provide you some sciatica relief! You can perform this routine 2-3 times a day if you like, but one should suffice.
1. Seated Spinal Twist
1. Begin seated on the floor with your legs extended out in front of you. For this explanation, let’s say our left leg is the one that is affected.
2. Bend your right knee and place your right heel as close as possible to your right sit-bone. Then, bend your left knee and cross your left foot over your right knee. Place it on the floor so that your left ankle is next to your right knee.
3. Reach your left arm behind you and place your palm on the floor. Then, bend your right elbow and cross it over the outside of your left knee. Keep your elbow bent, and if you can, hold onto your left toes.
4. Keep your left hand on the floor for stability, or bring your left arm around your lower back. Reach for your shirt, or hook your fingers on top of your right thigh. Gaze behind you and over your left shoulder. Continue pressing your right arm into your left knee, and use each inhale to lengthen the spine and each exhale to rotate further to the left.
5. Stay here for 1 minute, then release the twist and straighten out your legs.
2. Standing Hamstring Stretch
1. Put the foot of the affected leg on a support such as a chair, table, or bench. Your foot should be at or below hip level, with your leg straight and knees and toes pointing straight up.
2. If either knee tends to lock, protect them with a very small bend to prevent hyperextension.
3. For a deeper stretch, bend forward slightly over your leg at the hip crease, with your spine and leg straight and quadriceps firm. Hold for 1 minute and release.
3. Shoelace Stretch
1. From all fours, cross your right knee over the left (assuming the right is the affected leg), stacking one on top of the other. Sit down between your legs, rooting both sit-bones on the floor (you can rest on a block or blanket if one sit-bone is higher than the other).
2. Because we want to focus on the lower body, you do not need to do anything with your arms as you would with Cow’s Face Pose. Simply rest each hand on a foot.
3. Remain here and breathe, or to go deeper, fold forward and rest your forehead on your knee, stacked fists, or a block. Stay in this position for 1 minute and then release.
4. Standing Twist
1. Place a chair against a wall (you don’t really need a wall, but it will help you get deeper into the stretch).
2. To stretch the affected hip (let’s say the right side), stand with your right side next to the wall and place your right foot on the chair, with your knee bent about 90 degrees.
3. Keep the standing leg straight, and place your right hand on the wall. Turn your body toward the wall, using your hands for balance.
4. Allow the right hip to descend, keeping your hips level. Hold for 1 minute and release.
5. King Pigeon Hip Stretch
1. Sit with your right knee bent and your left leg extended behind you. Pull the right heel in toward your left hip. Make sure the left hip is always pointing down toward the mat. If it starts to open up toward the ceiling, draw your right foot back in toward the body.
2. Stay here with your hands resting on your right thigh or hips, or, walk your hands out in front of you so that your torso is resting over your right knee.
3. Hold here, and breathe into the tightness and tension for 5-7 deep breaths.
6. Supine Side Stretch
1. Lie on the floor with the legs flat, and raise the affected leg by placing that foot on the floor outside the opposite knee.
2. Pull the knee of the bent leg directly across the midline of the body using the opposite hand or towel until a stretch is felt. Do not force anything and be gentle.
3. Hold the stretch for 60 seconds, then return to starting position.
7. Figure Four Stretch
1. Laying on the ground on your back, cross the affected leg over the other with the ankle resting on the opposite knee.
2. Reach and connect your hands behind the hamstring of the non-bent side.
3. Gently pull the hamstring towards your belly and feel a stretch to the opposite side on the affected leg.
4. Breathe deep, hold for 60 seconds, and release.