When back pain isn’t really a pain in your back...
Now, I know what you may be thinking.
“Is this guy serious???” But let me tell you there is a muscle in your bum call ‘Piriformis’ and sometimes he has a lot to answer for.
But before we delve into the reasons let’s quickly look at the anatomy and give you a better understanding as to why this might be the case. The Piriformis is flat muscle with a pyramidal shape and sits deep in the buttocks and runs extremely close to the sciatic nerve.
The muscle stretches from the top of the femur to the sacrum on each side of the body and helps secure the upper thigh in the hip joint. The Piriformis muscle is mainly responsible for rotating the thigh laterally (outwards) and abducting (taking away from the body) the thigh when the hip is flexed (bent). Basically, the piriformis helps you to keep your hips stable while you are standing or walking. For a better understanding of these movements email me at the address below and I will send you an appropriate tutorial.
When the Piriformis is weak, tight or overworked it likes to complain. A result of this is tends to present as isolated low back pain and even sciatic pain. The sciatic pain is similar to sciatica in the respect that it can produce the same symptoms. The difference is the cause of the nerve compression and the location. Both causes can produce the same symptoms such as discomfort or numbness radiating down the leg into the calf.
So how do you know the difference?
If you sit for extended periods of the day and have just started physical activity or have had a big weekend in the garden and you have woken to a sore back before you jump to any conclusions have a go at performing some of these stretches/muscle releases to see if your symptoms improve. If they do, you are probably dealing mainly with a Piriformis issue which can be dealt with fairly easily.
Seated Piriformis Stretch:
Sitting up tall on a chair lift one leg and cross the ankle over the opposite knee. Place a little bit of pressure onto the knee (of the leg that is crossed) you should start to feel a stretch on the outside of your hip). To increase the stretch lean slightly forward. You should have a little bit of discomfort but do not push into pain. Hold the position for 20-30secs and repeat 2-3 times. Repeat this exercise 2 – 3 times per day.
Lying on your back place a spikey ball (tennis ball, golf ball – anything that is fairly firm) under your hips on the lateral (outside) aspect of the muscles in your butt. Roll the ball around until you find a sore point. Keep as much pressure on this spot as you can tolerate for 20-30secs before rolling off and finding a new spot (or the same one) and repeat. Work the ball around on both sides for 2-3mins and repeat 2-3 times per day.
It’s important to remember that muscles are susceptible both to tightness and weakness. If you have sciatica or lower back pain, make sure your Piriformis muscle is being assessed as a possible cause. A couple of stretches followed by some targeted strengthening can go a long way to alleviating your “back” pain.
To determine what strengthening exercises may be appropriate for you, connect with me today by shooting me an email: firstname.lastname@example.org. With the right plan you could be free of your "back pain" before you know it!
Michael - Stack Health Exercise Physiologist