Walking can be a real pain (no pun intended) if you suffer from Piriformis Syndrome. As we will review in this article, piriformis syndrome triggers a type of pain in the buttocks that is aggravated by physical activity. Walking can be especially painful for these patients. Therefore the question remains: Is walking good for piriformis syndrome and should you work your way around pain?
Piriformis syndrome and walking pain
Piriformis syndrome gets its name from the piriformis muscle, which is small but essential for walking. The piriformis is a triangular muscle that runs down from your sacrum to the thighbone, and it provides stability to your hip and core when you are walking. This is a very small muscle, but it is in close contact with the sciatic nerve, and irritation of the piriformis muscle may also cause sciatica pain.
In patients with the piriformis syndrome, this tiny muscle starts compressing or pinching the sciatic nerve. This nerve runs down the spine, giving branches to your legs and your feet. When compressed, the sciatic nerve sends pain signals to your brain and initiates a type of neuropathic pain that is very difficult to deal with.
Piriformis pain is very similar to sciatic pain, and it is often triggered by walking. However, it has certain characteristics of its own, such as a reduced range of motion and muscle alterations in the quadriceps. Thus, it should be ideally diagnosed by a doctor.
with thanks www.ncbi.nlm.nih.gov
The pain becomes especially bad if you don’t have an appropriate walking technique and posture. Severity is very variable. Sometimes it prevents patients from doing intense movements, but in severe cases, it might be triggered by running or even walking long distances. While it is not fully understood what causes the piriform syndrome, the resulting irritation of the nerve may even cause disability and reduce your quality of life.
Is there a way to solve the problem? Should you make an effort to keep walking, or is it better to stay seated and get a wheelchair?
Is walking good for piriformis syndrome?
Walking sometimes triggers piriformis pain, but that doesn’t mean that it is bad for you. Similar to many other forms of physical activity, walking releases endorphins in your nervous system. These chemicals have pain-relieving properties and may even counter inflammation. So, it is important to find a gray area where you perform the right amount of physical activity every day without triggering significant pain.
There’s an interesting approach to chronic pain named graded exposure. It turns out that people with chronic pain develop a fear of movement, which is not a good thing. Trying to avoid pain symptoms, they aggravate their disability and develop depressive symptoms, muscle atrophy, and increasing pain and disability.
In these patients, graded exposure helps patients go beyond their own boundaries instead of being limited by chronic pain. This modality of therapy for chronic pain is widely used in cases of muscle-induced pain, but it is also useful in neuropathic pain, including piriformis syndrome and sciatica pain. It is performed by gradually exposing the patient to their pain triggers with the right dosage of stress to overcome self-limitations without triggering a severe flare-up that requires over-the-counter medications.
In mild cases, walking and even running might not trigger pain unless it is performed over long distances or sustained for some time. In more severe cases, walking can be a form of graded exposure therapy for patients with piriformis syndrome. However, it should be adopted with care, and depending on the limitations of each patient.
It is not a good idea to walk over long distances in patients with severe symptoms, but it is even worse to adopt a sedentary lifestyle and aggravate your disability beyond the scope of your real limitations. Thus, you should ideally talk to your doctor about your symptoms, not limiting yourself and your own mobility, and adopting a few tips and tricks that will help you before, during and after walking and running to avoid pain symptoms and keep living an active lifestyle.
Walking tips to beat pain symptoms
It is possible to beat pain symptoms, even if you have a severe form of piriformis syndrome. There are many things you can do before, during, and after your walking sessions to avoid pain and enjoy the benefits of being active.
- Warm-up: It only takes 5 minutes to warm up before your walking session. Perform a few sit-ups, stretch your body a bit, and if you’re planning to run, start by walking slowly and then briskly for a couple of minutes.
- Use an appropriate walking technique: Your posture as you walk is essential to avoid pain. Stand up straight and avoid a poor posture. This will relieve tension in your back and reduce tension in your piriformis muscle. Another walking tip many people have found useful is to shorten your stride and slow down your pace. That way you reduce the chance of irritation to your sciatic nerve.
- Rest appropriately: You should also know when to stop and rest. Do not force yourself through pain, because it will only become worse, and you may end up with a severe flare-up. Start by walking short distances, where you can come back home and rest your muscles anytime, and do it when you start feeling pain. You can also apply ice or use a heating pad to prevent pain symptoms after walking.
- Stretch: When you’re not feeling any pain at all, you can also perform a series of movements and stretches that are specially designed for piriformis syndrome. They are called piriformis stretches and using them three or four times a day will give you significant improvement with your symptoms.
You don’t have to feel afraid of walking if you suffer from piriformis syndrome. Fear of movement will only make things worse, adding to your disability and mood problems. Walking is a very good exercise, even for patients with the piriformis syndrome, and if you follow a few tips, you will progressively reduce your symptoms and feel better.
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Boyajian-O’Neill, L. A., McClain, R. L., Coleman, M. K., & Thomas, P. P. (2008). Diagnosis and management of piriformis syndrome: an osteopathic approach. The Journal of the American Osteopathic Association, 108(11), 657-664.