Sciatica & Low Back Pain - How the Piriformis Muscle Causes Pain

by: PaulBoxcer
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Although Low Back Pain & Sciatica are two separate conditions, with the former relating to pain felt in and around the Lower Back region and the latter describing pain wihch travels down the leg, they share a lot of similarities with regards to their cause. One of several common causes between them is a tight Piriformis muscle.

The Piriformis muscle is situated deep within the buttock region, where it attached to the outside of your hip and also the outer part of your sacrum. As it travels between these two points, the Sciatic Nerve either passes through this muscle itself, or directly underneath (it varies from person to person).

Nevertheless, if this muscle tightens up it places increased stress upon the Sciatic Nerve and consequently can begin to aggravate it, leading to pain. With regards to Low Back Pain, one of the most important aspects is that this muscle is attached to Sacrum. Consequently, if the Piriformis muscle is tight, it will have an increased 'tugging' effect on this bone.

The Sacrum forms half of the Sacro-Iliac joint (Sacro referring to the Sacrum and Iliac referring to a specific part of the pelvis) and if the sacrum is being pulled on too much, there will be increased stresses placed across the Sacro-Iliac joint, which itself can ultimately lead to pain.

It is important I note here that Low back Pain also refers to pain from the Sacro-Iliac Joint, and not just the Lumbar Spine. The Sacro-Iliac Joint is positioned approximately where there are a couple of dimples just below your 'lower back'. If you think your pain is from this area, the likelihood is your pain is coming from your Sacro-Iliac Joint.

Moving on to Sciatica, if the 'highest' part of your pain is in the 'buttock' region, it is highly probable that a tight Piriformis muscle is responsible for your pain. You will need to stretch this muscle if this is the case.

There are several ways of stretching the Piriformis muscle, all of which would are best described with the use of a diagram. There is a link at the bottom of this article which will show you some Piriformis stretches.

There are alternatives to stretching, or maybe I should say additions to stretching, which are very effective at making this muscle more supple. One way is by using a small ball, such as a tennis ball:

Lie yourself on your back with your knees bent. Place the ball approximately in the middle of buttock on the side which needs to be massaged (this is approximately where the Piriformis muscle is). From there, gently 'roll' the ball by moving / rotating your buttock, so that the ball gently massages the area underneath.

This self massage exercise can be an excellent way of loosening up the Piriformis Muscle. However be careful, as it may also aggravate your Sciatica if the pain is still quite sensitive. This is because not only will you be massaging the Piriformis muscle, but also the Sciatic Nerve as it passes through or underneath it. Consequently, it may stir your pain up a little.

Do not worry yourself at all if you do happen to stir your pain up. I can assure you it will settle back down again. Nevertheless, this is your body's way of informing you that you are taking things forward a bit too fast. Stop performing that particular exercise until things settle down a little. When they have, feel free to start this exercise again, only this time make sure you are not quite as aggressive!

Exercises such as stretching and massage are an excellent way of loosening up a tight Piriformis muscle. Consequently, if it is tightness in this muscle which is responsible for your pain, your pain should soon begin to resolve itself.

About the Author

Paul Boxcer is a BSc (Hons) Physiotherapist.  

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