When sciatica type symptoms get the better of you and nothing you do seems to make it better, here is something you can do from my checklist for corrective actions and treatments Part 1.
Treat Trigger Points in affected muscles with neuromuscular techniques.
This is my favorite subject as a Neuromuscular Therapist.
Trigger Points are specific hyperactive and hypersensitive places in your body’s soft tissue that refer symptoms to another place from that spot. Because they are working 24/7, they never get a rest. Consequently, they use up all the nutrients and oxygen necessary for work which causes muscle spasms (and pain), and they give off waste products that accumulate, decompose and irritate the nerves (more pain). Trigger Points must be deactivated using Neuromuscular Techniques to reduce the local and referred pain.
With “sciatica” symptoms, I look at three muscles.
The first, the quadratus lumborum, is often the original problem. “Quadratus” means four-sided in Latin and “lumborum” indicates that the muscle in located in the lumbar region of the spine, at your waist between your ribs and your hip bone. The QL refers pain into the buttock from the sacroiliac (SI) joint across to the lower butt and down into the upper part of the back of the thigh. It also refers into the hip joint and above that into the top side of the hip. Sometimes it even refers into the abdomen, groin and down the front of the thigh. The part of the muscle closest to the spine is actually a ligament (iliolumbar), but it has the same referrals.
The second muscle I check is the scallop shaped gluteus minimus located in the side of your hip above the hip joint. It has been nicknamed the “pseudosciatica” muscle because it’s Trigger Points exactly mimic sciatica symptoms. One set of TrPs refers into the lower buttock and down the back of the thigh to the calf. The other set refers to the side of the butt and down the side of the thigh, knee and lower leg to the ankle. The muscle is underneath it’s partner gluteus medius and requires deep sustained pressure to release it.
The third major cause is the piriformis muscle. Doctors are paying more attention to it lately. It is a little muscle located deep to the much bigger and thicker gluteus maximus. TrPs refer from the SI joint across the buttock and hip and down the back of the thigh almost to the knee. Just as important is the fact that when it’s tight it can press on the sciatic nerve and cause big problems that include weakness and loss of function. The overlying gluteus maximus will be treated along with the piriformis. It causes mostly buttock pain.
While these muscles are being examined and treated, it is advisable for a therapist to check the hamstrings in the back of the thigh since all of the above muscles refer there and can irritate them.
After twenty years in practice, I find this complaint to be one of the most common. Consequently I treat these muscles every week in my Neuromuscular Therapy center near Boston.