Having a Pain in Your Butt - It May Not Be Sciatica

Feeling good about yourself because you finally decided to clean out the garage, but you're so sore the next day you can't move - particularly in your butt muscle? Many patients see us for emergency treatments this time of year because they did something out of the ordinary, such as: golfing; cleaning out the garage; raking leaves; or camping and sleeping with a rock underneath them. And now they are experiencing pain in the butt.

Many times these patients come in thinking they have sciatica. What they are actually experiencing is called piriformis syndrome. This common muscle injury can result from repetitive motion and over use of your piriformis muscle. Pain is often felt in the buttocks first, resulting in referred pain into the legs. This is commonly mistaken for sciatica.

What is Piriformis Syndrome?

The Piriformis muscle is a small muscle which originates in the base of the spine and inserts into the top of the leg bone (femur). The sciatic nerve runs through the piriformis muscle. If the muscle becomes tight, often from overuse, it can put pressure on the sciatic nerve and cause pain which may radiate down the leg. The piriformis syndrome often mimics sciatica, the difference is the origin of the pain.

Any muscle that is used repetitively needs a chance to recover. Imagine what happens to your piriformis muscle every time you swing a golf club. The repetitive and sudden swinging motion pulls the muscle, which eventually begins to spasm. When the piriformis muscle begins to spasm it will pull the hip bone causing the hip to become misaligned.

Treatment

The treatment for piriformis syndrome is to seek chiropractic treatment for the misaligned hip and a physical therapist/massage therapist for trigger point therapy and light stretching.

The self-treatment for piriformis syndrome is to use a golf or tennis ball (a cold one is best) on your butt or hip area. Sit on the floor and put your weight on the golf ball. Move the ball around until the ball is in the place where it hurts the most. If it's sore and hurts while you're sitting on the golf ball you're doing a great job! Toxins tend to accumulate in tight muscles and putting pressure on this area alleviates the toxins, and also breaks up the pain - spasm - pain cycle.

Other tips: Avoid the use of heat, use ice, and take ibuprofen if you need it. Visit your local chiropractor or physical therapist to help break up the pain - spasm - pain cycle.

Prevention

Regular stretching and strengthening are the best ways to prevent piriformis syndrome. This muscle rarely gets stretched, so a simple stretching routine often works wonders.

Stretch before you do any repetitive activity such as golfing, raking leaves, playing tennis, or doing extra chores around the house such as cleaning out the garage. Warm the piriformis muscle up by running in place, stretching the muscle, and getting chiropractic adjustments.

To stretch the right piriformis:

Lay on your back, bend your knees and cross your right leg over your left so that your right ankle rests on your left knee in a figure four position. Bring your left leg towards your chest by bending at the hip. Reach through and grab your left thigh to help pull towards your chest.

Sit on the floor with both legs extended out. Put your right knee over your left leg. Place the left arm over the right leg, twisting torso and pushing the right knee away from the left leg.

Hold both stretches for 30 seconds, repeat five times on the painful side. If stretching alone doesn't help, check with your chiropractor or physical therapist.