Pain in the butt

By Mary Lello

Lately I have been hearing a lot of people complaining about a deep, aching pain that begins in the center of their buttocks and travels down their leg. If that pain/ache travels below the knee and to the ankle or foot it is technically considered to be sciatica.

The diagnosis of sciatica means that there is inflammation of the sciatic nerve. The sciatic nerve is the largest peripheral nerve in the body, running from the lower segments of the spinal cord, passing behind the hip joint, and running down the back of the thigh and calf to the ankle.

Like most other nerves, the sciatic nerve performs two basic functions: first, it sends signals to your muscles from the brain; and second, it collects sensory information from the legs and passes this back to your brain. Conditions such as sciatica that affect the nerve will alter these normal functions. This usually manifests as either weakness of these leg muscles, pain in the legs and thighs, or both.

There are many conditions that can cause the sciatic nerve to become inflamed, including herniated spinal disc, spinal stenosis, and piriformis syndrome. Most often it is the latter, or piriformis syndrome, that is the main cause of the problem.

The piriformis is a small muscle that lies deep underneath the three gluteal muscles of the buttocks and is either above or below the sciatic nerve as it runs through the pelvic girdle. If the piriformis muscle becomes inflamed, tight, or spasming, it puts pressure on and irritates the sciatic nerve and you feel that deep, tooth-aching kind of pain in the center of your butt and/or traveling down one or both legs.

Sciatic pain usually goes away with time and rest. Most people with sciatica (80 to 90 percent) will get better without surgery. Conventional treatments might include physical therapy and stretches to help relieve the tightening of the piriformis. Muscle relaxants such as cyclobenzaprine (Flexeril) might be prescribed to relieve the discomfort associated with muscle spasms. However, these medicines all have side effects, including confusion in older people.

As a practicing acupuncturist for 20 years I have had great success in treating piriformis syndrome as well as the associated sciatica. Acupuncture is known to reduce inflammation and to relax muscle spasms. In this medicine the pain associated with the sciatic nerve is considered a condition of “stagnant Qi;” that is, the energy that runs through channels throughout the body is “stuck” in the channels that run down the legs. Acupuncture helps to move the stagnation of the Qi in the channel as well as reduce the inflammation of the piriformis and calm the muscle spasming that is putting pressure on the sciatic nerve. Many patients feel immediate relief after the first treatment for several days. Over the course of four to six treatments most find the pain is manageable or completely gone.

If you find yourself with a pain in the butt, you may just want to seek out acupuncture to reduce your discomfort and get back into balance for the coming ski season!

Mary Lello has 20 years experience as an acupuncturist, holds a master’s degree in acupuncture (MAc), is a Licensed Acupuncturist (LAc), and is a diplomate of the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). Her practice is at 101 Main St in Farmington. She can be reached at mlello445@gmail.com or by calling 866-266-5549. Lello is currently accepting some insurance with Anthem, Aetna and Cigna.