Can cycling cure sciatica

What helps with sciatica and back pain?

Status: March 21, 2021 9:39 p.m.

Back pain that radiates into the leg can have various causes. The intervertebral disc is not always to blame - the piriformis muscle often presses the sciatic nerve.

Around every third person in Germany occasionally suffers from back pain, and a fifth of people suffer from chronic complaints. If leg discomfort also occurs, the pain often comes from the sciatic nerve. Typical sciatic pain occurs suddenly and radiates through the buttocks and the back of the thighs, partially down to the sole of the foot.

Sciatica: Longest nerve in the body

The sciatic nerve (sciatic nerve) is the longest nerve in the human body. It is formed from several roots in the lowest part of the spine and runs through the pelvic muscles to the back of the thigh and on to the hollow of the knee. There it divides into two branches and extends on the outside and back of the calf to the foot.

Herniated Disc or Piriformis Syndrome?

If it pulls from the glutes down into the legs, the pain may indicate a herniated disc. But studies show: although slipped discs are often clearly seen on MRI images, they are often not the cause of the symptoms.

Another cause should be considered before the operation: the piriformis muscle can be to blame. It is hidden under the gluteal muscle and connects the sacrum and thighs. Usually the pear-shaped muscle is soft and stretchable. But it can become tense and shortened as a result of a fall, poor posture or excessive strain. The muscle becomes thick and hard and presses directly on the sciatic nerve (piriformis syndrome). This can trigger radiating pain in the buttocks and legs as well as tingling and abnormal sensations.

Experts estimate that many disc operations could be avoided if piriformis syndrome was properly diagnosed and treated beforehand.

Lasègue test provides information

The so-called Lasègue test can be used to find out whether the sciatic nerve is irritated and could therefore be the cause of the leg pain. In this test, the leg extended at the knee is slowly moved towards the ceiling when the patient is lying on their back. If there is severe pain in the leg up to a certain angle, there could be sciatica irritation. Using certain pressure points, the doctor can determine whether the piriformis muscle is causing the discomfort.

Piriformis Syndrome: move, massage, stretch

If the piriformis muscle is identified as the cause of the pain, movement, relaxation and stretching are the therapy of choice. In order to relieve the tension, the physiotherapist must also check all neighboring muscles and, if necessary, loosen them, as they are often involved. The often chronically tense muscle can be loosened with shock wave therapy and manual therapy. The squeezed sciatic nerve is relieved of pressure as much as possible and the symptoms improve.

Resolving piriformis syndrome can take several weeks to months. If the pain has persisted for three to six months, it is referred to as chronification. In addition to pain medication, physiotherapy and manual therapy, those affected can keep the piriformis muscle relaxed and elastic at home with simple stretching exercises - and thus live without this pain if possible.

Botox injection provides relief

If the piriformis muscle causes discomfort even after several weeks of therapy and consistent self-exercise, Botox injections can be used as a relatively new method in this area. The active ingredient botulinum toxin paralyzes the muscle. This reduces the tension, the piriformis muscle no longer presses on the sciatic nerve. A botox injection is often given under MRI guidance. The effect lasts for about three months - if the muscle shrinks, this can also lead to permanent relaxation in this muscle.

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The Movement Docs | 03/22/2021 | 9:00 p.m.