Syndrome sciatique et piriforme :
Une perspective fonctionnelle
Qu'est-ce que la sciatique et le syndrome piriforme?
Sciatica and piriformis syndrome describe pain and other symptoms resulting from irritation of the sciatic nerve. Symptoms can be experienced in the lower back and down either or both legs, even to the toes. Symptoms may include pain, shooting pains, burning, tingling, cramps, weakness, numbness, and loss of muscular control. Approximately 40% of the population may experience sciatica symptoms or piriformis syndrome in their lifetime.1
Le nerf sciatique est le nerf le plus grand et le plus épais du corps humain, et il est responsable d'une grande partie de la sensation et du contrôle moteur des jambes et des pieds. Les nerfs sortant de la colonne vertébrale entre la quatrième vertèbre lombaire et la troisième vertèbre sacrée se rejoignent pour former le nerf sciatique, qui traverse les fesses et tout le long de chaque jambe.
Sciatique (formally referred to as lumbar radiculopathy) occurs when the sciatica nerve is compressed as it exits the spine.
Chronic tightness or spasm in the piriformis muscle can also compress the sciatic nerve, causing Syndrome du piriforme. Many of the symptoms of sciatica and piriformis syndrome are the same; the distinction is made based on where the nerve compression occurs.
Le nerf sciatique
Le muscle piriforme
Causes de la sciatique et du syndrome piriforme
In about 90% of cases, sciatica is caused by a herniated disc compressing the root of the sciatic nerve.2 Other causes include degenerative disc disease, spinal stenosis, spondylolisthesis, pregnancy, tumors, or infection.
Sciatica typically begins as a functional issue. The structural issues that occur in the lumbar spine to cause sciatica are most often a result of the way we function: the way we habitually sit, stand, and move. Repetitive daily activities, athletic training, and heavy lifting can cause repetitive compression of the lumbar spine or make lower back muscles chronically tight, constantly compressing the lumbar spine. This compression can cause discs to thin and herniate, vertebrae to move out of alignment, the spinal canal to narrow, and bone spurs to develop.
Likewise, piriformis syndrome typically results from the way we use our bodies. Athletic training or imbalanced posture and movement patterns can cause the piriformis muscle (a gluteal muscle) to become chronically tight, compressing the sciatica nerve.
Comment prévenir et soulager la sciatique et le syndrome piriforme
The best way to prevent and alleviate sciatica and piriformis syndrome is to release chronic muscular contraction in the lower back and gluteal muscles, and retrain damaging posture and movement patterns that could be causing compression of the lumbar spine.
Clinical Somatic Education uses a highly effective movement technique called pandiculation that works with the nervous system to release chronic, involuntary muscle contraction. Clinical Somatics exercises also retrain posture and movement patterns, preventing pain and structural damage and allowing you to use your body in a natural, efficient way.
Clinical Somatics exercises are highly effective in relieving sciatica and piriformis syndrome. The Level One & Two Courses teach exercises that release involuntary muscular contraction in the lower back and gluteal muscles, relieving pressure on the sciatic nerve. The exercises are slow, gentle, and suitable for all ages and physical abilities.
Les références
1. Valat, J.P.; Genevay, S.; Marty, M.; Rozenberg, S.; and Koes, B. (avril 2010). “Sciatica.” Clinical rheumatology. 24(2): 241–52. http://www.bprclinrheum.com/article/S1521-6942(09)00141-7/fulltext
2. Koes, B.W.; van Tulder, M.W.; and Peul, W.C. (juin 2007). Diagnosis and treatment of sciatica. British Medical Journal, 334(7607): 1313–1317. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1895638/