Trigger points in the piriformis muscle, a deep lateral rotator muscle in the pelvis, was shown to be responsible for the vast majority of sciatic pain (sciatica), and was able to be successfully treated without back surgery, a 2005 study by the Cedars-Sinai Institute for Spinal Disorders revealed.
In the study, 239 patients were evaluated - these patients either had not improved after diagnosis or treatment for a herniated or damaged disc. 7 of the patients were found to have torn disc related conditions, such as annular tears, and were successfully treated with spine surgery.
The 232 patients who remained underwent a new kind of magnetic resonance technology called magnetic resonance neurography to evaluate the sciatic nerve. 69 percent of the patients - 162 - were found to have piriformis syndrome (where the piriformis muscle traps or irritates the sciatic nerve), and the remaining 31 percent had a number of other nerve, muscle, or joint conditions in varying locations that were not seen by a standard MRI.
Only 62 patients needed surgery to correct the piriformis syndrome - such surgery included Open MRI guided imagery, where the MRI scanner guides a deep injection of a pain medication into the muscle or nerve. This treatment corresponds with what Janet Travell and David Simons recommend in their groundbreaking book, Myofascial Pain and Dysfunction - the Trigger Point Manual. In the book, they recommend a physician inject a local anesthetic into the location of a trigger point, causing its release.
The other patients in the study received manual therapies, such as physical therapy and exercise, and had successful outcomes as well.
A massage therapist who is trained in releasing trigger points can effect the kinds of changes brought on by the Open MRI guided imagery, as well, by using ischemic compression and other techniques. The beauty of science research is that for over 70 years, medical professionals thought that sciatica was caused by damaged or herniated discs. Now we know that the vast majority of cases are muscular in origin, and that other methods of treatment are as or more effective than surgery.
Cedars-Sinai Medical Center (2005, February 2). New Way To Diagnose Sciatica May Point To A Different Cause. ScienceDaily. Retrieved December 12, 2007, from http://www.sciencedaily.com /releases/2005/02/050201192443.htm
