Sciatica is one of the most common conditions I see in my practice. For reasons I’ll explain below, it often goes along with back pain, which 80% of Americans will experience at some point in their lives. Luckily, sciatica is typically relieved when the underlying cause—chronic muscular tightness—is addressed.
What is Sciatica?
The sciatic nerve is the largest and thickest nerve in the human body. Nerves exiting the spine between the fourth lumbar vertebra and the third sacral vertebra come together to form the sciatic nerve, which runs through the buttocks and all the way down each leg.
The sciatic nerve is responsible for much of the sensation and motor control of the legs and feet. Sciatica symptoms are generally caused when the nerves exiting the spine are compressed between the vertebrae by a bulging disc pressing against the nerve roots, or when the sciatic nerve is compressed after it has exited the spine. When the sciatic nerve is compressed you may feel shooting pain, a burning sensation, or numbness or weakness in your legs and feet.
In a small portion of the population, the sciatic nerve runs through a gluteal muscle called the piriformis instead of underneath it. For these people, chronic tightness in the piriformis can compress the sciatic nerve, causing piriformis syndrome. The symptoms of sciatica and piriformis syndrome are the same; the distinction is made based on where the nerve compression occurs.
Addressing the Underlying Cause
Sciatica and piriformis syndrome are most often caused by chronic muscular tightness in the lower back and gluteal muscles, which causes compression of the vertebrae, discs, and the sciatic nerve. This is why back pain and sciatica so often go together; the underlying cause of most back pain conditions is also chronic muscular tightness.
The most effective way to relieve sciatica and piriformis syndrome is to release the chronic muscular contraction in the lower back and gluteal muscles. Sounds easy enough, right? Most people would try stretching or getting a massage to release tight muscles, but these approaches provide only temporary relief.
To get lasting relief, you must change the messages that your brain is sending to your muscles to stay tight. This can only be achieved through an active learning process that consists of very slow movements that retrain your nervous system. By gently contracting and releasing muscles in movements called pandiculations, you can release chronically held muscular tightness. Sciatica and piriformis syndrome symptoms typically clear up swiftly once the compression is relieved by releasing the chronically tight back and gluteal muscles.
Dr. Thomas Hanna developed the technique of pandiculation, and it is part of his method of Clinical Somatic Education. This method retrains the nervous system, releasing chronic muscular tightness and retraining learned postural and movement patterns. By addressing the underlying cause of many pain conditions, Clinical Somatic Education provides lasting relief.