Sciatica From Low Back Spinal Disc Herniation VS Piriformis Syndrome Sioux City
Pain that travels from the back down the leg to the foot is called sciatica, which is a general term for radiating pain. The term does not describe what tissue is injured, or why. In fact, several distinct injuries can cause sciatic pain, with lumbar spinal disc herniations, piriformis syndrome, and sacroiliac sprains being the three most common.
Piriformis syndrome is commonly misdiagnosed as a spinal disc herniation, because the pattern of radiating pain, from the back to the lower leg, is similar in both injuries. With both injuries, people experience pain with the same type of motions and movements, particularly rising from a seated position, standing for prolonged period of time, or sleeping. As well, the pain associated with both injuries feel better when you lay on your side and curl up in the fetal position.
A spinal disc herniation occurs when the jelly-like substance from inside the lumbar disc compresses the spinal cord or nerve. Either the disc material directly compresses the nerves when squeezed out of the disc, or else the compression of the nervous tissue is caused by inflammation, created by the body attempting to absorb the jelly. A spinal disc herniation is a severe injury, causing an immense amount of back pain and limitation. Some people lose sensation in their legs. They may experience numbness and tingling throughout the day. Many have dull, burning, tingling, or sharp pain in their back, glute, and leg. Compression of specific nerves causes muscles weakness and loss of sensation in different parts of the leg.
Treatment for Disc Herniations
Treatment involves helping the body break down the spinal disc material, and relieving the compression of the nerves. Spinal disc decompression treatments are very effective treatments for disc herniations. Flexion distraction therapy is also a great method for decreasing pressure in the low back. Many patients benefit from at-home use of inversion tables. Light exercises and stretches are used to decrease muscle spasms and increase movement in the low back joints.
Massage therapy is focused on the back, glutes, and hamstring muscles to decrease spasms and to reach the lumbar spine and pelvis. Many patients with spinal disc herniations have weakness in their core muscles, which need to be strengthened with proper therapy so as to increase strength, endurance, and muscle coordination patterns. Patients with a chronic history of low back injuries or previous disc herniations benefit immensely from core strengthening to prevent future injuries.
Piriformis Syndrome and Treatment
The piriformis muscle is a very strong and powerful muscle that runs from the sacrum to the femur. It runs underneath the middle and lower gluteal muscles, and the sciatic nerve travels underneath it. If this muscle goes into spasm, it compresses the sciatic nerve, creating radiating pain, numbness, tingling, or burning from the glutes into the leg and foot. Many people do experience back pain with piriformis syndrome. Others develop piriformis syndrome after an acute low back sprain or while dealing with chronic low back pain.
Activities and motions that cause the piriformis muscle to contract further compress the sciatic nerve, causing pain. This muscle is contracted when we stand, walk, go up steps, or squat. It tends to tighten when we sit or stand in any position for longer than 20 to 30 minutes.
People who have a history of chronic low back pain often assume their radiating sciatic pain is traceable to their low back. Their history of back sprains, strains, or disc herniations has taught them to always assume that the pain is from their back, and that it will go away like usual. In this case, it is only when the pain does not respond as usual that people seek treatment, thus delaying their recovery by weeks.
Treatment for piriformis syndrome involves decreasing the intensity of the piriformis muscle spasm that is compressing the sciatic nerve. Light massage therapy, trigger point therapy, ice, heat, electric, and light stretching are very commonly involved in the early stages of care. Deep massage therapy is not advised in the early stages of piriformis syndrome. Some of the pain may be relieved during the therapy, but people often experience worsening symptoms the next day. When the piriformis muscle is worked too deeply it may relax for a short period of time before it goes into a bigger spasm—further worsening the sciatic pain.
Chiropractic Treatment For Back Pain
Chiropractic treatments and therapy goals are to increase joint range of motion and decrease muscle spasms. Piriformis muscle spasms often increase stress and strain on the sacroiliac and lumbosacral regions, which further increases low back pain. Chiropractic treatment restores normal motion in these regions. Therapy and treatments to increase flexibility and decrease spasms accelerate healing and recovery times for many types of back pain.
Often, people aggravate their piriformis muscle when they are guarding or protecting their low back. They may have insufficient strength and ability to squat, bend, turn, and twist—thus, to compensate, they overwork their gluteal and piriformis muscles. Treatment should focus on increasing strength and endurance of the pelvic and core muscles, to reduce future strain and piriformis injury.
Both piriformis syndrome and spinal disc herniations produce radiating pain from the low back and into the leg. They are, however, two distinct injuries, requiring separate treatments for normal healing and recovery. They are both commonly associated with low back weakness and poor flexibility. Treatment should address not just the acute injuries but also the core weaknesses that led to the condition.