What is sciatica?
Sciatica is a common term used to describe pain and/or altered sensation into the leg/s due to damage or irritation of the sciatic nerve. Nerve roots emerging from the lower segment of your spine (the lumbar spine) combine to form a large nerve called the sciatic nerve. The sciatic nerve is a thick flat band approximately 2 cm wide and it is the largest nerve in the body. This nerve emerges from the pelvis and into the gluteal region, it then emerges from the gluteal region just under the piriformis muscle and goes down the back of the leg.
Sciatic nerve damage or irritation has many causes, one of the most common, and probably easiest to rectify, is the Fat Wallet Syndrome.
What is the fat wallet syndrome?
Fat wallet syndrome, is a neuromuscular condition, where the wallet is compressing the sciatic nerve and the piriformis muscle.
Over the last couple of decades, wallets have progressively become bigger. The number of cards we carry – credit, fuel, store etc have increased. Add to this the photos, paper receipts, coins, appointment and business cards have all led to the increased girth of our wallets. The wallets are carried in the trouser pockets and more often than not, it was in the back pockets.
When we sit with a wallet in our back pocket, we are effectively sitting with a slight tilt of the pelvis. The wallet creates an imbalance in the weight distribution in the pelvis and in the long term causes repeated stress to the piriformis muscle (leading to spasms) and sciatic nerve compression.
The syndrome has been well-described in men and is also commonly known as: wallet neuritis, wallet-neuropathy, wallet sciatica, and fat wallet neuritis.
What are the symptoms?
Symptoms mimic sciatica and can range from
- Pain on sitting or driving
- Pins or needles on the leg
- Altered sensation in the leg
- Numbness in the foot
- Difficulty in walking
Treatment
Start by removing the source of the problem, the wallet, and place it into the front or jacket pocket. In the acute phase, over the counter pain killers can help alleviate some of the discomfort, but these should only be taken for 3-4 days if self-prescribed. Can you reduce the size of the wallet by decluttering it? Most people have smart phones that have the ability to carry digital cards which reduces the need to carry physical cards.
Get advice from your therapist
- Correcting postural habits is an important part of the rehabilitation. These habits are likely to be carried out both frequently and unconsciously, and are adopted during the course of sitting, standing or working.
- A strengthening and stretching program is recommended so as to prevent further episodes.
Here at Woodside Clinic, our team of physiotherapists and osteopaths have the expertise to help you.
If you have any further queries, please contact the team at Woodside Clinic on 01582 608400 or 01525 372447.
References
Edwards (2005) The importance of postural habits in perpetuating myofascial trigger point pain ; Acupuncture in medicine
Teja et al (2016) Fat wallet syndrome: A Mini Review ; European Journal of Biomedical and Pharmaceutical Sciences
Chalal et al (2018) Fat Wallet: syndrome an epidemic among men ; International Journal of Medical Research & Health Sciences
Siddiq (2018) Piriformis Syndrome and Wallet Neuritis: Are They the Same ; Cureus
Black (2018) From Piriformis Syndrome to Deep Gluteal Syndrome . Practical Neurology : Topic Pain
Jung et al (2020) The Effects of Cross-Legged Sitting on the Trunk and Pelvic Angles and Gluteal Pressure in People with and without Low Back Pain ; International journal of environmental research and public health
Lim et al (2021) A triz-aided approach in exploring wallet neuropathy and hip pocketing issues ; ARPN Journal of Engineering and Applied Sciences
FAQs
The wallet creates an imbalance in the weight distribution in the pelvis and in the long term causes repeated stress to the piriformis muscle (leading to spasms) and sciatic nerve compression.
Can a fat wallet cause sciatica? ›
[6] Long-term use of a hip pocket wallet can cause sciatica-like symptoms that are difficult to differentiate from spinal conditions. Preventing fat wallet syndrome is straightforward by keeping the wallet in the front pocket.
How do you treat wallet sciatica? ›
In the majority of cases wallet sciatica is effectively treated with physiotherapy, with short-term symptoms often resolving within only a few days. More longstanding piriformis syndrome symptoms may however take weeks to address.
Can sciatica be caused by being overweight? ›
Lots of factors can cause or contribute to sciatic nerve irritation and compression, including repetitive bending or lifting, back strain, or poor posture. Today, being overweight or obese is recognized as a common contributing factor to sciatica and its symptoms.
Why am I suddenly getting sciatica? ›
Sciatica occurs when the nerve roots to the sciatic nerve become pinched. The cause is usually a herniated disk in the spine or an overgrowth of bone, sometimes called bone spurs, on the spinal bones. More rarely, a tumor can put pressure on the nerve.
What makes sciatic nerve worse? ›
Moving Incorrectly. Lifting and bending forward incorrectly can definitely cause sciatica symptoms to act up. The sciatic nerve runs over the buttock on its way to the leg so moving incorrectly can spike an increase in pain as the muscles rub against the sciatic nerve.
Can a wallet mess up your back? ›
Storing your wallet in your back pocket can lead to discomfort in the short term and potential health issues in the long term. Sitting on a bulky wallet for extended periods can cause misalignment of the spine and contribute to back pain.
How do I get rid of sciatica ASAP? ›
Other self-care treatments that might help include:
- Cold packs. Place a cold pack on the painful area for up to 20 minutes several times a day. ...
- Hot packs. After 2 to 3 days, apply heat to the areas that hurt. ...
- Stretching. Stretching exercises for the low back might provide some relief. ...
- Medications.
Sciatica usually heals on its own with rest and time. To help relieve the pain, treatment may include: Nonsteroidal anti-inflammatory (NSAIDS) medicines such as ibuprofen. Heat or cold applied to the sore muscles.
How do you reset sciatica? ›
7 stretches or loosening up your sciatic nerve
- Seated piriformis stretch. Your piriformis muscle is located deep within your glutes, and spasms in this muscle can result in sciatica pain. ...
- Child pose. ...
- Standing hamstring stretch. ...
- Knee-to-chest exercise. ...
- Pelvic tilt exercises. ...
- Glute bridges. ...
- Lying deep gluteal stretch.
For our patients with ongoing or severe sciatica, we recommend physical therapy and epidural injections. Because weight places extra stress on your lumbar spine, losing weight not only eases your sciatica pain, but it also may prevent it from turning into a chronic pain condition.
What to do when your sciatica is so bad you can't walk? ›
Self-treatments can include:
- Ice. Cold or ice packs can help reduce pain and swelling during the first few days after sciatica pain starts. ...
- Heat. After the first several days of using cold or ice, switch to a heating pad or warm compress. ...
- Over-the-counter medicines. ...
- Stretching and activity.
The answer is yes — most cases resolve within six weeks from the onset of symptoms. Sciatica that lasts for three months or longer usually indicates the presence of an injury. Despite this, sciatica rarely requires surgery. Surgery is usually reserved for extreme cases connected to a spinal disorder or injury.
What is the number one exercise for sciatica? ›
The safest way to work out with sciatica is to look for low-impact (usually cardio) exercises. The most common options are: Riding a stationary bike. Walking.
What is the most successful treatment for sciatica? ›
You can usually treat a mild case of sciatica yourself with a combination of heat, ice, over-the-counter pain medication, and stretching and strengthening exercises. For more severe pain, your doctor might recommend physical therapy, steroid injections, or surgery.
What is the root cause of sciatica? ›
Common causes of sciatica include: Slipped or herniated disk. Spinal stenosis. Piriformis syndrome (a pain disorder involving the narrow muscle in the buttocks)
Can a wallet cause back pain? ›
A wallet in your back pocket hurts your posture and can cause back, neck and shoulder pain. This is because a wallet in the back pocket causes uneven pressure on the spine. When sitting, the pelvic and the hips are the foundation for the rest of the upper body.
Can carrying heavy things cause sciatica? ›
The heavy lifting that you did during your move may indeed have led to your case of sciatica. Incorrect lifting can contribute to one of the main causes of the condition, which is a bulging, herniated or misaligned disc in the spine, which presses on the sciatic nerve.
Can wallet in back pocket cause hip pain? ›
Many men carry their wallet in their back pocket, and so many women cross their legs when they sit. These may be habits most people do not think would be causing harm to the body, but indeed they can be causing a variety of symptoms including low back pain, hip pain, and knee pain.
What trigger points cause sciatica? ›
The trigger points commonly (almost always) associated with sciatica are found in piriformis, and gluteus maximus.
