Getting to know and understand your sacrum can shed a lot of light on sciatica and piriformis syndrome as well as sacroiliac dysfunction.

Sadly, an increasing number of people are beginning to discover the pain and discomfort of piriformis syndrome and sciatic nerve pain known as sciatica. Estimates suggest that about 5% of cases of sciatica (irritation of the sciatic nerve causing radiating pain from the back or buttock into the leg, calf, and foot) are due to piriformis syndrome. It seems to be more common among women though the reason for this is not known.

Piriformis Syndrome

This irritation can cause pain, numbness, tingling, and shooting sensations in the buttocks and hip, and sometimes in the thighs and legs. Piriformis syndrome can be a chronic condition, a one-time injury, or a recurring source of pain.

Tension and tightness in the piriformis muscle can cause the muscle to spasm and create inflammation. This tightness and inflammation then presses on the sciatic nerve leading to OUCH!


Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body.

Sacroiliac Dysfunction

There are many different terms for sacroiliac joint problems, including SI joint dysfunction, sacroiliac joint disease, SI joint syndrome, SI joint strain, and SI joint inflammation. Each of these terms refers to a condition that causes pain in the SI joints from a specific cause. Basically, there is a misalignment between your sacrum and pelvis, and normal movements are interfered with. There are a number of causes including degenerative arthritis (osteoarthritis), pregnancy, gout, rheumatoid arthritis, ankylosing spondylitis, and others.

Your Sacrum

The gently curved sacrum consists of five vertebrae which fuse together by the age of 25, and form a single wedge-shaped bone which is connected to both the last lumbar vertebrae and the ilium bone of the pelvis.

Being mindful of your sacrum during everyday movements can go a long way toward relief and prevention. Yes, put your mind in your sacrum!

Simple Tips That Help

Standing up / sitting down in general:
Tuck your tailbone under your body hold in your abdomen and use your thighs—not your back— to bear your body’s weight. Lift like you (properly) would lift a heavy object and sit like you would perform a (proper) gym squat.

Getting in and out of a car:
Tuck your tailbone under your body hold in your abdomen as you begin to move. Swivel until you are fully facing out of the car and then place both feet flat on the ground before lifting yourself (see standing up / sitting down above) out of the car or sitting down

Keep both sitz bones on the seat. Don’t cross your legs and don’t lean to one side when you sit. Take all objects out of your back pockets when you sit. Firm, upright seating that allows you to sit upright and keep both feet on the floor while not allowing your spine to curve is the best. This also makes getting up a whole lot easier. Comfy deep leather seating is not your friend 🙁

Best if you can sleep flat on your back. For side sleeping, don’t lie with your top leg reaching over and past your bottom leg. This puts your spine into a twist and your pelvis puts strain on the piriformis muscle. Train yourself to sleep with both hips and knees stacked on top of each other. If you put a pillow between your knees this can help keep you from rolling forward. Sleeping on your stomach is the worst sleeping position for pain.

Try to relax and let your hips move. If you walk guarded and don’t let your hips swing, you are tensing and shortening the muscles in your lower back.

DO IT! Anything you can do to keep moving (mindfully of course). I know it will be hard, but I guarantee you that if you stop, it will begin to hurt worse and your health will suffer. Tai Chi is a great place to start. The movements are low impact, slow and mindful and relaxing. There is no sitting and no floor work to put pressure where you don’t need it.

In General:

  • Asymmetrical movements of your hips/pelvis are not your friend.
  • Be very mindful of your movements.
    Keep moving!
  • Find a local Tai Chi or Qigong class 😉

Videos for Relief

VIDEO Piriformis Pain Relief – Reclined Movement

VIDEO Piriformis Pain Relief – Standing Movement

Student Bonus!

Just Breathe students can download a copy of The Pelvis and Your Sacroiliac Joint Pain, a class article with more information on the topic and illustrations.