Sciatica – a pain in the @rse

A couple of weeks ago I began to experience a pain in my right leg that started in my right buttock and hip. At first I ignored it. Then, as it began to get worse I was forced to acknowledge that it was actually there, and it was beginning to impact on my ability to walk and run normally. Or sit. I’ve had this before many years ago, and it is the dreaded sciatica. Sciatica is not a condition in itself, but a symptom of something. There are several reasons why the pain can start, including disc problems and muscle tightness.

The sciatic nerve is a big nerve that derives from the lumbosacral plexus L4 -S3. The nerves join to become the thickest nerve in the body, which can be as thick as an adult thumb. It enters the gluteal region (buttocks to you and me) via the greater sciatic foramen in the pelvis, and leaves inferiorly to the piriformis muscle to descend through the hamstrings. At the top of the popliteal fossa (back of the knee – well actually just above) it divides into the tibial and the fibular/peroneal nerves descending to the lower leg and foot. As it goes down the leg it branches out to innervate all areas of the leg and foot.

The piriformis muscle is deep within the muscles of the buttocks, and the sciatic nerve can get “squashed” by it, leading to painful symptoms. This is often called “piriformis syndrome”. It causes pain in the bottom, hip and down the leg, even into the feet. It can also cause numbness and tingling all down the leg affected.

What causes it? In my case probably overuse! I think it started after I came back from a weekend in Cornwall when I walked a lot, and ran too. The steep cliff path was very hard on my legs and glutes.

Luckily piriformis syndrome is generally a self-limiting condition which means it will go away on its own in the end. When the pain has been really quite bad I have taken ibuprofen. I am also trying to stretch the piriformis muscle. This website has a good description of what is going on and how to address it.

Ten days on from the worst of the pain, and I can safely say that the pain is beginning to subside. Which is a good thing, as I am currently half way through a walking holiday along the South Downs Way in Sussex.

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