Sciatica, Piriformis Syndrome, Gluteus Minimus, or…?


Pain in the low back, gluteus/buttock muscles, low limbs, even to the feet, possibly including pins and needles or numbing. Who’s the culprit for all this physical discomfort? Once it starts interrupting our ability to find a comfortable sleeping position, we all want to know. Lower lumbar vertebrae impinging on the sciatic nerve (sciatica), or the piriformis muscle under the glutes compressing that same nerve? First off, wise to get things assessed properly. A good physical therapist or orthopedic doctor are solid professionals for covering musculoskeletal pain and imbalances. Second, keep in mind sciatica and piriformis syndrome are very often composite problems, meaning there are several influences creating the issue. As I focus continually on in this blog, other soft tissue imbalances can be adding to the problem, sometimes even the sole cause. 

Segue to gluteus minimus, a key player in creating mid-lower body pain patterns (though not the only one, sorry ;). Find this muscle on a nice, basic anatomy drawing. Found in the posterior to lateral portion of the hip, it is the deepest of the three glute muscles, attaching in at the front and top of the femur/upper leg bone. If it’s hypertonic/too tight, a large referral pattern of pain, weakness, pins and needles, and/or numbing can present from the hips all the way to the feet. A tennis or lacrosse ball is a great tool to start easing the tissue out of excessive tension, breaking down adhesions and interrupting pain signals from the tissue. Best to stay off the tendon attachment to avoid irritating a bursa/”cushion” located there, or the tendon itself. Stay about an inch away from the head of the femur bone, keeping in the belly of the soft tissue encircling that greater trochanter/top of the femur. This will all make more sense after glancing at an anatomy drawing – maps of the body are interesting, just try!

The area can be surprisingly tender or sharp feeling. Using a sports ball and having massage done will reveal these sensations, often recreating familiar pain patterns. No need for torture! A dark laugh at how sore it may be will keep the breath going if needed, but if the breathing stops and the swearing escalates, best to lighten the pressure or address another time. Let the physical sensations be the guide. Follow the tension in the tissue – coax and ease it open, backtracking it out of dysfunction and discomfort. Trouble sleeping on that side? Try using the sports ball right before bed, follow with a couple of gentle stretches to the glutes. Getting good bodywork done to the area really feels so relieving. Sensing pain and imbalance being led out of an area leaves us all feeling so much lighter, in spirit as well as in form.


Copyright © by Lara Stillo 2018