Have you ever had a tooth-achy pain in your rear-end that drove you crazy? Many times the pain comes out of no where and can be so sharp and intense that it stops you in an instant.  These could be symptoms of sciatica. Let me talk a little bit about the causes of sciatic pain.

Common causes are spinal stenosis, which is a decrease of space in the spinal canal most commonly due to excess arthritic bone formation or a disc herniation. Another cause is piriformis syndrome, which is a muscle in the buttock region that runs just over the sciatic nerve. When this muscle tightens or spasms, it puts pressure on the sciatic nerve and in a small population, the sciatic nerve actually runs through the belly of this muscle. Pregnancy can also cause sciatic pain due to the change in posture and pressure increase on the nerve.

    Some at home exercises to try would involve stretching the piriformis muscle by lying on your back, crossing one leg over the other and pulling the top thigh to the chest. Hold this stretch for about 15 seconds, but no bouncing. Make it a solid hold and repeat on both sides. (See the picture for placement.) You can also place a tennis ball on the area of discomfort and light sit and shift your weight on top of it to get more of a trigger point effect. It is important to remember that the piriformis muscle is a postural muscle which means it will rarely be found to be lax. The muscle also functions as a lateral rotator, so if you notice your toes are pointing out more as you walk, the piriformis muscle is most likely tight.

    Especially for men, do make sure they do not sit on their wallet. This extra inch or so changes the placement of the tailbone and puts pressure directly on the sciatic nerve. Many times, just simply removing the wallet from the back of the pants decreases the pressure on the nerve instantly. 

    Back extension exercises also will decrease pressure on the nerves if the problem is due to a disc issue. The intervertebral discs herniate more posteriorly, so to lean back a little bit causes the disc to move anteriorly and back into its place.

However, with these simple remedies, it is always important to determine what the cause of the sciatic pain is. For diagnostic purposes, X-rays should be taken. Soft tissue work like Active Release Technique (ART) can help decrease the pressure put on by the piriformis muscle and decrease swelling. As chiropractors, we have special equipment and adjustments to help get the spine back in alignment.