Remembering back to the spring of 2012, my ever present battle with an inflamed sciatic nerve began. I have been seeing a chiropractor since I was two years old … so how could someone like me be hit with such an annoying affliction?
The sciatic nerve begins in the lower back and runs through the butt all the way down your leg to your toes. This nerve can lay above, through, or below the piriformis muscle. The piriformis muscle lies between the base of your spine and the very top of your thigh deep in your buttocks, it assists in rotating your leg. In some cases sciatica is not even an issue stemming from a misaligned back but from the piriformis being compressed. The compression causes irritation to the sciatic nerve (especially when it is positioned through or below the piriformis muscle). This background history, along with a note that many piriformis syndrome sufferers have glutes that fail to activate, will help you see why the treatment plan I have followed for the past six weeks has finally provided me some relief.
In January, I had started a new job that offered great coverage from Blue Cross Blue Shield. Coinciding with this change, I decided to look for a new chiropractor. I had two reasons for doing so. First, I wanted to find a practitioner that accepted my insurance, and second, I needed to find someone who could provide me with more relief. I had had the same chiropractor for all of my life, age 2 through 22. It was hard to leave someone I knew so well, but I had to try something different.
My new chiropractor turned out to be a holistic wonder. She was not only a licensed chiropractor but also a certified acupuncturist. Providing others with pain management is her life’s work and mantra. I went to her for my first consultation and she sent me for a few more X-rays before my adjustment. After my first exam and reviewing my X-rays she walked me through a treatment plan. The therapy and recovery began.
My first four visits consisted of 20 minutes of massage therapy working on my lower back and piriformis muscle and then being adjusted. The massage used acupressure/trigger point technique to target my knotted muscles. My previous chiropractor did work with fascia briefly before adjustments (I’ve never been a fan of cold adjustments that last all of 5 minutes in the doctors office) but she never went to this same extent to prepare the muscles and fascia to move with the spine. This massage phase of treatment was crucial and was supplemented by two 55 minute massages from my massage therapist. Following this, I could actually begin to strengthen and retrain my body.
My next 4 visits were focused on physical therapy. We tweaked my piriformis stretch and hamstring stretch so I leaned forward from the hips with a flat back. I’m very flexible so even though I thought I was doing this correctly a second pair of eyes was crucial in making this stretch effective. My chiropractor also had me perform various stretches utilizing the PNF (proprioceptive neuromuscular facilitation) stretching technique. We focused on strengthening my core with the dead bug exercise (using a foam roller for increased instability) and with wobble board exercises to balance on one foot and both feet as well as during functional movements like throwing or bouncing a ball.
My biggest issue comes back to the piriformis. Many people with piriformis syndrome have glute muscles that normally fail to activate. Mine activate – just not in the correct order. I tend to originate moment from the lower back and the hamstrings and then follow those large muscles with my glutes. I’ve had to retrain my body to activate glutes first, followed by the opposing hamstring and low back muscle. This is a big deal when you are walking. If you would like to try some of the exercises I did to retrain my muscles, you can check out glute kickbacks, prone(stomach) leg extensions, clamshells, and cross crawl. The most important thing to remember when performing these exercises is that you MUST FOCUS on your glutes. They need to learn that they are the major players.
I am now in the phase where I have to keep up my physical therapy as home maintenance. I can always schedule a massage if I’m in pain and am trying to lessen my chiropractic appointments from once a week, to once every two weeks, and then eventually monthly. At the beginning of this journey I couldn’t sit for even half of a work day without sciatic nerve pain. Now I can get through 3/4 of a day and it’s much less aggravating. Sitting all day isn’t ideal. But I’m glad to have found a pain management plan that seems to be helping. Results and baby steps are crucial to long term success!