Is Sciatica a Pain in Your Butt?

It can be! A common place for the sciatic nerve to be compressed is underneath the piriformis muscle, which is one of your deep glute muscles! However, it's not the only place where the sciatic nerve can get trapped. Just because you have pain in your glutes, it doesn’t always mean it's Sciatica. It's important to understand the root of the glute problem in order to treat it most effectively! ;)

The Path of the Sciatic Nerve

The sciatic nerve is the longest nerve in the human body, starting from the nerve roots in the lower lumbar spine and sacrum (L4- S3) and running down to the foot. Given its extensive path, it can be pinched or irritated at various points, leading to a different path of symptoms based on where the compression occurs. The two most common points of irritation: 

• Lower Back: When the group of nerve roots that form the sciatic nerve get irritated here it often results in a shooting pain radiating down the entire leg, including the glutes. If the shooting pain is taking a different path than that of the sciatic nerve then it’s likely that other nerves are being affected. 

• Piriformis muscle: Pinching in this area can cause pain in the butt and thigh that may radiate down the leg. If it stays local then we’re dealing with an issue that’s more muscular. 

The sciatic nerve (the longest nerve in your body!)

Identifying the Source of Pain

Correctly identifying where the nerve is being pinched is crucial for effective treatment because we want to take an upstream approach to treatment and treat the root cause, instead of just the symptoms. 

Part of identifying what we’re experiencing starts with describing what we’re feeling. A nerve pain can be described as a shooting, tingling, numbing sensation that follows the path of a nerve. A muscular pain is going to be more dull, achey, or sore. Of course, pain is subjective so these might vary, but I find that it helps to have a list of words as a starting point. 

Ok Great. Where do we start?

Let’s address the two most common compression sites:

1. Low back: 

• Chiropractic adjustment: After performing a thorough exam to determine which nerves are being affected we can deliver a chiropractic adjustment to relieve pressure in those joints. 

chiropractic adjustment to address the lumbar spine

• Nerve flossing: contrary to popular belief/ natural instinct nerves don’t like to be stretched; in fact, this can sometimes make the pain worse. Instead, we want to gently push and pull the nerve back and forth to release tension. 

Start by sitting on end of bench. Flex head towards chin as you flex the knee and kick foot underneath simultaneously

Then extend head and extend leg simultaneously

2. Piriformis muscle: 

• Myofascial release: A great way to relieve tension in the piriformis muscle is a manual release or instrument assisted mysofascial release (massage gun, etc.) of the piriformis muscle.  

• chiropractic adjustment: Adjusting the pelvis can be a great way to open up space in the sacroiliac joints to relieve pressure

• Stretch: The classic figure 4 stretch. Can be done seated or lying on back. 

Figure 4 stretch

Preventing Sciatica

Preventing sciatica involves maintaining a healthy spine and avoiding activities that may strain your back. Regular exercise, good posture, and proper lifting techniques are key to preventing nerve compression. Refer back to the blog post on the three best exercises for low back pain to maintain proper spinal hygiene specifically in the low back. 

Conclusion

Sciatica is more than just a "pain in the butt"; it's a complex condition that requires a nuanced approach to diagnosis and treatment. By understanding the true nature of sciatica and where it originates, you can take the necessary steps to alleviate your pain and prevent future flare-ups. If you suspect you have sciatica, consult a healthcare professional to get an accurate diagnosis and appropriate treatment.

Feel free to contact us for more information or to schedule an appointment. We're here to help you find relief and get back to enjoying your life, pain-free.