Sciatica refers to pain caused by compression or irritation on the sciatic nerve which will normally present as pain starting in the lower back or buttock radiating down the back of the leg and sometimes into the foot. Several issues may cause sciatica including lumbar disc injury, piriformis syndrome or a more serious issue such as spinal stenosis. Symptoms such as pins and needles, numbness or lower limb weakness may be an indication of a more serious pathology, therefore it is important to have your pain properly assessed by a physiotherapist so that an accurate diagnosis can be made.

In runners Sciatic pain is most commonly caused by piriformis syndrome, which occurs as a result of the piriformis which is a deep gluteal stabilising muscle, causing impingement on the sciatic nerve as it runs directly in front of the muscle or through it (in 10% of people).

Symptoms, causes and prevention/treatment of sciatic pain will be discussed in relation to a typical piriformis syndrome.


Pain usually presents in the buttock on one side, radiating down the back or outside of the upper leg and sometimes into the calf, there may be some intermittent pins and needles/numbness into the leg. Pain in the buttock is normally a dull ache which is made worse by long periods of sitting, walking or running. The glutes will normally feel tight with hip rotation movements and have deep pressure points which are tender to palpate.


Tightness of the piriformis muscle resulting in impingement on the sciatic nerve is the cause of pain and there may be several factors which cause the muscle to become tight. The piriformis is responsible for externally rotating and abducting the hip and can become tight and over-worked when the other gluteal abductor muscles especially the gluteus medius are weak.

Other factors which may lead to development of a tight piriformis include a leg length discrepancy, rapid increase of mileage or training intensity, training on hard surfaces or a sudden impact injury which places a high load through the glutes such as falling and landing on the buttocks.

Prevention and Treatment

Like all running injuries an initial period of offloading is essential, so it is important to reduce your running load at the onset of pain. Using some simple strategies such as heat pack application, analgesic medication and gentle glute stretching can also help reduce muscle tension.

As discussed above it is very important to have any sciatic pain assessed by a professional to determine it’s cause so that the most appropriate treatment can be prescribed. The Front Runner Physiotherapists can provide you with all of the assistance you need to ensure you are back running as soon as possible without doing any further damage.

Simple prevention strategies you can use are regularly stretching and foam rolling after training sessions, include some regular hip strengthening and pelvic stability exercises in you weekly training routine to reduce instabilities and avoid training overload by following a periodised approach.


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