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
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.
If you have any further queries, please contact the team at Woodside Clinic on 01582 608400 or 01525 372447.
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