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It Hurts When I Sit

“Why does it hurt when I sit?”

Pain while sitting is a common complaint. Unfortunately, the cause of the pain can vary. For this post, we’ll focus on a condition call “piriformis syndrome”. This syndrome typically causes pain in the low back, buttock and backside of the upper thigh. One of the most common complaints with this issue is pain while sitting.

Let’s dive a little deeper into the anatomy of the area to figure out why this happens. The piriformis is a small muscle that stretches across the buttock from the hip to the sacrum (just above the tailbone). The sciatic nerve is a large nerve that starts in our low back and runs down the backside of the leg all the way to the bottom of the foot. This nerve travels under the piriformis in the buttock area. If it’s tight, the extra compression of sitting will irritate the nerve and cause pain in the areas I mentioned earlier. This condition can span the spectrum of pain intensity. On one end, it can be an occasional dull background pain and on the other end, it can be a constant intense pain that limits function.

Sometimes it can be hard to differentiate between piriformis syndrome and other conditions, like disc herniations, which can cause the radiating pain down the back of our leg. Typically, piriformis syndrome radiates down the back of the leg but doesn’t cross the knee. If it’s a disc herniation, the pain will often times radiate down the leg past the knee and into the calf, ankle or foot. This isn’t always the case but along with a good history and exam, it can be helpful in determining the root cause.

How do you treat piriformis syndrome?

There are a lot of options for treatment of this condition. Dr. Crabtree uses a specialized soft tissue treatment called, Active Release Technique®. He likes to describe it as a movement based massage. It’s a technique that is effective at reviving soft tissue function and mobility. Chiropractic adjustments can help restore normal joint function in the pelvis to help relieve strain on the piriformis. Stretching is another important piece to recovering from piriformis syndrome. Whatever you do, it’s important to seek help from a healthcare professional when dealing with issues like this. It’s important to have an accurate diagnosis before beginning any treatments or rehab options.

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