Sciatica and Myofascial Pain

walletitis

Men, do you keep your wallet in your back pocket?  If you answered “YES”, then please read on.  Keeping a wallet in your back pocket can create pressure on the piriformis muscle.  The sciatic nerve runs through the piriformis muscle.  Repeated pressure on this muscle will cause inflammation and sciatic pain, commonly called sciatica or piriformis syndrome.  If that were the only issue, it could be a minor problem of simply stretching the piriformis muscle to undo the damage created.  However, many of us are sitting for long periods throughout the day.  I believe that it’s safe to say that we probably do not sit with the best posture at our computer for 8+ hours each day.  With that in mind, we are now adding an unbalanced sitting foundation to our already compressed and compromised sitting posture.  Repeating and maintaining a compromised posture for any period of time can set up a cascade of postural compensations which eventually can lead to a myofascial pain pattern, or pain referred to other areas of the body.

Please refer to our previous article on proper sitting posture (https://www.handson-austin.com/proper-sitting-posture-to-avoid-and-eliminate-pain/).  That article has important tips for proper sitting to avoid neck and back pain.   The pelvis is the lowest part of the spine.  The nerves from the lower part of the spine exit and travel down each side of the spine, traveling through the buttock region down to the targeted muscles in the legs.   The wallet generally sits directly over the muscle belly of the piriformis, making it most vulnerable to inflammation.  Even 1/8 of an inch in variation of the position of the pelvis can be enough of a difference to cause inflammation.

The piriformis muscle assists in moving the leg out sideways from the body and rotating the thigh outward.  Pirifomis inflammation will generally cause pain in the buttocks and refer pain anywhere along the course of the sciatic nerve, which travels from the back and down the back of the thigh.  Sciatica can be aggravated by sitting, climbing stairs or performing squats.  Because fascia will adapt to the postures that we are maintaining, if we are sitting on an unbalanced foundation, the trunk with torque or twist in order to maintain a midline posture.  This happens without us having to consciously make that adjustment.   This compensation sets up the potential for additional myofascial pain patterns further into the trunk, rib cage, head and neck.

Fun Fact, although it was popularized by an episode of the “Seinfeld” series in the 1990’s, the phenomenon was first described in a brief article in The New England Journal of Medicine in 1966, when credit cards were beginning to proliferate.  The report, about a lawyer who suffered aches and pains in the left leg, not far from a wallet growing thick with charge cards, referred to the condition as “credit-carditis.”  Although that term never quite caught on, doctors say the condition has become increasingly common. Its onset is gradual, caused by an object placed in the back pocket.

Wallets are not the only culprits. Numerous case reports have linked the condition to various back-pocket objects such as large handkerchiefs.

The bottom line, keeping anything in your back pocket, such as a wallet, can cause an imbalance in the pelvis with resultant potential for sciatica and myofascial pain patterns anywhere else in the body.

What can you do about it?

*Stretching the piriformis-  lie on your back, flex the hip and knee, pull that knee towards your opposite shoulder.  To change the length of the fascia, hold that position at least 2 minutes.

*Have your posture assessed.   Choose someone who understands myofascial pain and is trained in myofascial release techniques.  They will not only look at the area of pain, but also above and below to assess areas of compensation.

*Myofascial Release treatment by properly trained practitioners will get you your best value for eliminating pain, restoring proper function.

*Periodic Myofascial Release treatment is an important self care, wellness support for anyone that moves.

The therapists at Hands On (www.handson-austin.com) and Verde Valley Myofascial Release (http://www.verdevalleymyofascialrelease.com)  are expert Myofascial Release practitioners.   If you are in pain, or just want to maintain and or improve your current state of wellness,  schedule an appointment today.

Jody Hendryx, PT, LMT

Posted in: Wellness & Self Care

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