Sciatica: What a Pain in the Buttocks!

Sciatica. Clinically, many people have come to me for this issue. People often use this term as a diagnosis, but sciatica is actually just a symptom. It is defined as pain going down the back of the leg, following the sciatic nerve distribution. There could be many causes to this pain pattern, and we will be going through some of them in this article.

Sciatic pain is characterized by pain in the back of the leg, ranging from pain in the buttocks only, to extending down all the way to the toes. It is also sometimes associated with numbness and tingling in the leg or foot.

So what is causing this pain?

Sciatica is a symptom of a pinched nerve, called the sciatic nerve. The sciatic nerve can be pinched at many locations. The two most common locations that I see in clinic is impingement in the low back and in the buttocks. Here is a picture of the sciatic nerve (see picture 1).

Picture 1: Sciatic Nerve and Sciatica

As shown by the previous picture, nerves branch out from the lower back and merge together to form the sciatic nerve, which travels down the back of the leg. If this nerve gets pinched, it can refer pain all the way down to the toes.

Sciatica – Pinched in the back

A VERY common cause of sciatica is nerve impingement in the low back. Nerves comes out of the back between each segment of the spine. A bulging disk can decrease the space that the nerve passes through and cause sciatica (see picture 2).

Picture 2: Bulging disk and Sciatica

Herniated Disk?! Now what?

A disk herniation is generally not irreversible, so no need to panic! To treat sciatica caused by a herniated disk, treatment should be targeting the low back. We will talk about disk herniation in our future post. Physiotherapy and the McKenzie Method is VERY effective at treating sciatica!

Sciatica – Pinched Nerve at the Butt!

Another very common location that sometimes causes pinching of the sciatic nerve is on the buttocks, more specifically, by a very deep muscle called the Piriformis (see picture 3). The sciatic nerve passes underneath this muscle. If the piriformis is tight, it cause cause more pressure on the sciatic nerve, thus causing sciatic pain. Typically, if this is the location of the impingement, the individual will mostly have pain on one of their buttock, and little to no pain in the low back.

(Picture 3) Piriformis Muscle

How Do I Treat Sciatica?

Physiotherapy is a very effective solution for treatment of Sciatica. You will go through an assessment and find out the actual cause of your pain and first of all, to make sure it IS sciatica. We will then determine the source of your pain, where is the nerve being pinched at. Usually, we will be able to tell you your diagnosis on your first session and form a treatment plan that will get you back to 100%!

About the Author

Lily Zhang

Lily Zhang is a registered physiotherapist with training specializing in the McKenzie Method.  She graduated from McGill University and is currently working in Barrhaven (Ottawa, ON). She has over 10 years of professional training/clinical experience in orthopedic physiotherapy.  You can Follow Her Blog @PhysioVive Facebook Page.

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  1. Pingback: What You Need to Know About Sciatica - Physiovive

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