Wallet neuritis, a compressive tunnel neuropathy, where ipsilateral sciatic nerve gets compress from exogenous wallet beneath the piriformis muscle, proliferating clinical features mimicking lumbago sciatica.
This condition is most common among men than women due to they keep a wallet in their trousers back pocket which over a period of time commonly gives rise to a condition termed as “wallet neuritis” or “fat wallet syndrome”. This condition leads to compression of the sciatic nerve and involvement of the piriformis muscle and provides sciatica-like features, it’s difficult to differentiate sciatica from wallet neuritis.
Causes
Prolonged sitting on an uneven surface
Prolonged exposure to heavy wallet or phones
At a 32-mm wallet thickness, gluteal discomfort increased. These results indicate that sitting for brief periods (15 minutes) on an uneven seating surface greater than 32 mm in thickness causes postural deviations from neutral spine positions and increases gluteal discomfort.
If you have made it a habit to sit with your wallet or phone in your back pocket or sit on an uncomfortable chair or stool, that can be a predisposing factor to occur wallet neuritis.
When you sit on your wallet prolonged-time period, that may result,
Alter posture of pelvis
Alter alignment of the lumbosacral spinal segment
Mounting pressure on pelvic muscles, intervertebral discs, nerve roots, and nerves unevenly
Mounting pressure on the piriformis muscle
Muscle imbalance
Increase stress on sacroiliac joint
Signs and symptoms
Lower back pain
Gluteal and ipsilateral lower extremity pain, tingling, and burning sensation
Radiating lower extremity pain
Piriformis sign positive
Tenderness present over the piriformis muscle
Pain on standing, sitting, and/or lying for 15 to 20 minutes or more
Pain worse with driving and sitting
How to avoid wallet neuritis?
Keeping your wallet in a front pocket or jacket.
Keep your wallet in your bag/briefcase. Placing your wallet in your front pocket or bag/briefcase will save you pain and your money.
Make arrangements to fix your sitting habits and get more ergonomic seating by getting advice from your physiotherapist. The patient should avoid postural and movement issues. It might save you from further pain, and help you recover quicker.
Don’t use heavy/thick wallets, those are more than 32mm thick.
Make sure to remove heavy wallets during sitting.
Physiotherapy treatments help to reduce pain, muscle imbalance, paresthesia, due to wallet neuritis, and also you can get advice from your physiotherapist on how to sit on a chair correctly to avoid wallet neuritis.
Dilini Anuradha
References
https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204659/%23:~:text%3DWallet%2520neuritis%2520is%2520an%2520example,%252Dgling%252C%2520and%2520burning%2520sensation.&ved=2ahUKEwjIlsGkstDtAhXOwjgGHR-bCyMQFjABegQIAhAE&usg=AOvVaw12g7QCBBMNUXWHoVm7FwBu
https://paininjuryrelief.com/what-aggravates-piriformis-syndrome/
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