When putting together a good back pain management programme, you must take into consideration the condition known as piriformis syndrome/impingement.

Piriformis syndrome/impingement is caused when the sciatic nerve which originates from the lower back, and is the main nerve root for the other nerves that innervate the lower extremities is being squeezed. This nerve runs either through in 10% of the population or just in front of the piriformis muscle. The piriformis is a muscle that lies beneath the gluteas maximus muscle (large muscle of the buttock area). Its main function is to turn the leg out.

Piriformis syndrome/impingement is when the muscle is tense (in spasm) on an ongoing basis, this can be caused by overuse, e.g. long distance running, even jogging or standing all day at work etc.

It can sometimes be caused by a weakening of the muscles through a lack of use e.g. sitting at work for the majority of the day, although other muscles would be involved as they would weaken also, this will cause the piriformis to overwork and go into spasm. You must make sure your back pain management program takes in all aspect of this condition.

One of the indicators of this condition is a problem with turning your leg out and getting a pain in the buttock area; you may not always get this pain, but still have difficulty with turning the leg out, you may also experience pain in the back of the thigh and calf.

This can also present itself as a pain located in the lower back. This can be diagnosed by your treatment provider as sciatica, when you also experience referred pain sent to your lower extremities.

As part of your back pain management treatment of this condition you need to incorporate a stretching/flexibility component of the piriformis and strengthening exercises. Your back pain management program must always have exercises for the core muscles of the body, as they support the spine like a corset. These exercises and stretches can be done on your own in your own environment, through a therapist or even a personal trainer who understands the condition and can put together a good back pain management program for you.

This will help the piriformis to relax thus removing the pain and stiffness associated with piriformis syndrome/impingement.

When you begin to put together your back pain management programme, put down the points that need to be tackled.

Flexibility
Strengthening
Core stability
Massage
Diet (if needed)

Once you put down a few points for your back pain management programme it will be easier to put all the points you need and not miss anything. You can always ask your treatment provider, a therapist or a qualified personal trainer.