Let’s look at a very common issue that many of you may have experienced at some point; Sciatic Pain or literal ‘pain in the butt’.

I have seen this issue countless times in my career and many have suffered with this off and on for decades. Certain positions or activities tend to flare it up. Some report there is no rhyme or reason for it; it just rears its ugly head making life absolutely miserable. Let’s look at some reasons why this issue occurs and why some things will aggravate it. Then we will look at what can help it resolve.

Your sciatic nerve is deep in your buttocks (one on each side) and can produce severe pain deep in the butt as well as down your leg all the way into your foot. I want to be clear that if there is numbness or pins and needles or tingling there may be involvement at the spinal level; not just sciatic nerve irritation.

If you have sciatic pain it may be due to a sacral torsion. You see, your piriformis muscle is a very deep muscle that attaches to your sacrum (the upside-down triangle bone below your spine with the bottom point being your tailbone) and your greater trochanter (the bump on the outside of your hip bone). If your sacrum is torqued, it will pull abnormally on your piriformis. When a muscle is pulled on, it pulls back, like a tug of war. Your piriformis may be in a low-level spasm, putting pressure on your sciatic nerve. Statistics show that ~85% of the population has their sciatic nerve positioned under the piriformis so if this muscle spasms it can create pain in the buttock, and often down the leg.

Your piriformis is a hip rotator and it contracts when you walk or bear weight so that is why walking and standing can be so painful. We will look at how it happens and how to fix it in the next blog.

~ Eileen Kopsaftis, PT