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The piriformis muscle is a frequent site of sciatic nerve impingement.

Sharp pain, numbness, tingling and a burning sensation in the back of the legs are common symptoms of sciatica. In severe cases, weakness in the legs may also present.

The sciatic nerve is the largest nerve in the body, running from either side of the lower spine through the buttocks, thigh and continuing to the foot. It includes several smaller nerves and originates in the spine at the lower back. Irritation of the sciatic nerve at any point along this path is referred to as “sciatica.”

The type of discomfort and the patient’s individualized sciatica symptoms are typically indicative of the location of the injured/irritated nerve. Although nerve entrapment can occur in a number of places in the human body, the two most common are at the origin of the spinal nerve, and where the nerve extends beneath the piriformis muscle.

Both respond well to chiropractic adjustments, although the treatment method can vary dramatically from patient to patient.

Sciatica Related to Nerve Irritation at the Spine

When there is a mechanical dysfunction of spinal joints, nerves can become irritated or “pinched” as they exit the spine. In addition to becoming sandwiched between two bones, spinal nerve irritation can result from bulging discs, encroachment by bony overgrowth, or “stuck” to surrounding soft tissues (muscles, ligaments, fascia).

Treatment of Sciatica Related to Joint Dysfunction or Bone Malposition

Chiropractic adjustments are an effective treatment for sciatica related to joint dysfunction or bone malposition. Restoring the dysfunctional joints to their normal position and movement alleviates pressure on the nerves, thus reducing the painful symptoms of sciatica. Sciatica related to disc injury often requires supplementary treatment methods, such as The McKenzie protocol and the Cox Flexion/Traction—. both of which are available in our White Plains office. The objective of the McKenzie protocol is relieve the symptoms of sciatica by applying sustained pressure to the injured disc over sequential treatments. This technique serves to restore the disc to its original shape.

The Cox Flexion/Traction method employs a uniquely designed chiropractic table that manipulates and elongates the spine thus relieving pressure within the disc. Both techniques can deliver immediate pain relief, and are proactive in preventative maintenance.

Treating Sciatica Caused by Bulging Discs

Non-Surgical Spinal Disc Decompression can alleviate the symptoms of sciatica due to herniated/bulging discs, using the DTS Spinal Decompression technique. By gently reducing spinal disc pressure, this painless, non-invasive therapeutic treatment is the foremost non-surgical alternative for treating sciatica, pinched nerves, and herniated discs.This technologically advanced procedure is the most effective, non-invasive treatment available. Generally, our DTS patients experience a significant pain reduction within just a few sessions. DTS Therapy works to gradually straighten the spine and alleviate disc, joint and muscular tissue pressure while augmenting the body’s natural healing process.

Sciatica Related to Entrapment at the Piriformis Muscle

The sciatic nerve progresses alongside, or travels through, the piriformis muscle, and runs down the back of the leg before finally diverging into lesser nerves ending in the feet. Piriformis muscle spasms can result in pinched nerves. A normal healthy sciatic nerve glides smoothly within its sheath, without adhering to the piriformis muscle. It is crucial that this nerve maintain proper elasticity in accordance with spine and leg movements.

Injury, trauma, or repetitive motions can cause inflammation in the piriformis muscle, which can lead to the formation of scar tissue. These bands of scar tissue, or adhesions, then bind the piriformis muscle to the sciatic nerve. When this occurs, stiffness in the lower back, hips or legs will present. Left untreated, symptoms can progress, resulting in sharp pain, numbness, tingling and weakness in the buttocks or back of the legs.

Treatment of Sciatica Related to Entrapment at the Piriformis Muscle

The objective is to detach the piriformis muscle from the sciatic nerve, which is most effectively achieved by implementing the Active Release Technique (ART). This approach is an interactive process involving both doctor and patient. Every Active Release session is actually a unique combination of examination and treatment. Dr. Donath applies controlled pressure with a thumb or finger at the site of adhesion while manipulating the specific body part through a complete range of motion. During this process, the tissue is held stationary while the nerve is gently separated from the adhesion. Oftentimes, clients experience immediate symptom relief, and are able to regain flexibility and strength.

Chronic stiffness of the piriformis muscle can result from a dysfunction in the hip or sacroiliac joint, as well as an anterior pelvic misalignment (pubic symphysis). Common causes include running, cycling, prolonged sitting, and trauma to the leg or foot.This condition can also originate during pregnancy and/or childbirth.

Chiropractic care is a gentle, safe, and effective treatment for sciatica and related conditions, and restores health and balance to supporting muscular system.

Focusing treatment solely on the muscle is merely a “Band-Aid,” and would likely provide only temporary relief, as the dysfunctional joint will remain as such. Thus, over time, the muscles return to an imbalanced state. The results would be similar in treating only the joints. Therefore, treatment comprised of both chiropractic adjustments and restorative ART therapy is most conducive to achieving optimal results.