What's Sciatica?

A Pear-Shaped Problem

Not all cases of sciatica are brought on by a damaged disc. The condition can be brought on by anything pressing on or irritating the nerve, including a bone spur (an overgrowth of bone caused by unusual wear and tear), bursitis, tumors or infection. You can even develop it from sitting on your wallet!

Pregnancy can aggravate sciatica by putting added stress on the lower back. A woman's protruding abdomen causes an exaggeration of the normal curve in the lower spine and narrows the exit sites of the sciatic nerve between the vertebrae.

Another common cause of sciatica is piriformis syndrome, so called because of the involvement of the piriformis, a short, thick, pear-shaped muscle that runs from your sacrum, the lower part of your pelvic bone, to the head of your femur, or upper thigh bone. You use this muscle when you extend your hip or rotate it outward. In most people, the sciatic nerve cord runs near this muscle.

Sciatica results when the piriformis compresses and irritates the sciatic nerve in the buttocks. The pain is a dull ache in the middle buttocks, often worse at night because of the cumulative effects of using the muscle all day. Numbness and weakness can come and go or not be present at all.

You may find it difficult to climb stairs, walk on an incline, use the stairclimber or do step aerobics. For a woman, intercourse may be painful on the side of the affected muscle. Pain can shoot back up the nerve to your lower back or can continue down your leg.

For some reason, piriformis syndrome occurs six times more frequently in women than in men. Half of the cases result from a traumatic event, such as a fall or direct blow to your rear end, or something as simple as twisting your back while serving a tennis ball.

You can also get piriformis syndrome from overusing your hip muscle or sitting for too long on a hard surface. You may be predisposed to sciatica if you have tight hamstrings or if one of your legs is longer than the other. Men can develop sciatica from carrying their wallet in their hip pocket, where it can press on the nerve.

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