Most of us have heard of sciatica — pain that begins in the hip and runs down your leg. Sciatica usually stems from the pressure or irritation of nerves in your lower back. One other condition that compresses those nerves is called piriformis syndrome.
Piriformis syndrome causes sciatica due to compression of the nerve as it passes through the pyramidal piriformis muscle. Sited deep in the buttock, the piriformis muscle fibers run diagonally from the sacrum to the hip. In the hip, the sciatic nerve passes underneath or through the piriformis muscle. It is this relation of the sciatic nerve to the piriformis that makes the nerve vulnerable to repeated stress and irritation.
Various factors can incite the piriformis syndrome. One of the most crucial of these is when constant, firm pressure is applied over the piriformis muscle, such as during prolonged periods of sitting.
The pain of piriformis syndrome starts in the buttocks and radiates down the length of the sciatic nerve (the back of the thigh and leg). The condition can be debilitating. Nipping the pain in the bud is, therefore, of utmost importance before it impairs the quality of your life.
Exercise therapy represents the keystone of treating both the piriformis syndrome and sciatica. Various piriformis and hip stretches can be tried to curtail the painful symptoms of nerve entrapment and improve the range of motion in your hips. Stretches involving the hamstring (a string-like group of three muscles along the back of your thigh) and hip extensor muscles can also provide pain relief from sciatica.
If this is you, congratulations on taking the first step towards a healthier you and fixing your pain! Let's get started.
Warm Up your Hip Muscles
Warming up and prepping your hip muscles is crucial before stretching them out.
For this, lie flat on your back and gently bend your knees up towards your chest. Place your hands on your knees as if hugging them, pulling them towards you. Hold this posture for 5-30 seconds, and slowly lower one knee down, followed by the other.
This exercise not only serves as a great warm-up but also gives you a good back and piriformis stretch.
Do a Cross-body Piriformis Stretch
- Continue lying on your back.
- But this time, bend the knee of the affected side and cross it over to one side such that the heel of that side comes to rest on the opposite thigh area just above the knee.
- Use your hand to gently push your knee (of the affected leg) away from your body until you feel a gentle stretch around your hip. Think about making a “figure four position” and aiming that knee towards the opposite shoulder.
- Hold the stretch for 5-30 seconds and release. This posture will give your piriformis an incredibly nice stretch.
- To beef up the stretch, you may continue holding the figure-four stretch and take a belt or strap to grab the underside of the unaffected thigh on which your knee is resting. Pull that thigh toward your chest. Hold it for 5-30 secs and release.
The piriformis muscle may be too tight in some people, and overstretching can worsen sciatica. Hence, while doing the cross-body stretch, try to go only as far as you can without aggravating your pain. That said, some discomfort is fine if you want to benefit from the stretch.
Try the Advanced Version - Pigeon Pose
- Start off by sitting on your feet.
- Come forward to all fours (in a crawling position, with both the hands and knees on the floor).
- Then slowly bring the leg of the affected side forward and bend that knee so that it touches the outer edge of your mat while your lower leg and foot are resting on the opposite side of the floor. It’s best if you can position your knee in line with your hip.
- Lean a bit forward and extend the other leg back until it is straight.
- Lower your upper body down so that your forearms can take up all the weight. You may also put a block under the affected hip. The idea is to help take as much pressure off the pose as possible.
- Take a few deep breaths, holding the pose for at least five breaths.
- Relax and repeat the entire sequence.
Turn Both Knees to one Side
At the end of your piriformis stretching routine, take time to cool your muscles down. For this:
- Lie on your back.
- Stretch your arms out straight so that they are at your shoulder level and in contact with the floor.
- Unlocking your elbows, gently drop both knees to one side while the upper body remains as it is.
- Stay in this posture between 5-30 seconds.
- Slowly return your legs to the starting position.
- Repeat on the other side.
- Repeat the entire steps two to three times.
Bonus Ergo Tips
Sitting for prolonged periods, especially when carrying a wallet in the back pocket, can fan the flames of sciatica from piriformis syndrome. On the other hand, avoiding excessive sitting by periodically switching between sitting and standing can offer plenty of benefits.
If your chair and desk are not ergonomically designed well, making a few healthy changes can also have a hefty impact on your pain levels. Invest in a height-adjustable desk or standing desk converter to easily transition from sitting to standing and vice versa, and enjoy a pain-free life!