Fat Wallet Syndrome

Nerves of the right lower extremity Posterior view from Gray’s Anatomy (not the TV show but the book) via Wikimedia Commons

Fat wallet syndrome. It’s not an economic condition. I didn’t even know it was a condition until I was listening to an interview on Fresh Air with author Michael Chabon and he mentioned it.

Piriformis syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed or otherwise irritated by the piriformis muscle causing pain, tingling, and numbness in the buttocks and along the path of the sciatic nerve descending down the lower thigh and into the leg.

A numb ass.

And it plagues men more than women. [pause for laughter]

You can do a search on the syndrome and find lots of information, but I’ll give you a short version. I think I am suffering from it myself.

An overuse injury is often the cause. I wish I could say that for me it comes from activities performed in the sitting position that involve strenuous use of the legs as in rowing/sculling and bicycling. This gluteal pain sometimes radiates down your butt and down your leg.

But, piriformis syndrome is also known as “wallet sciatica” or “fat wallet syndrome,” as the condition can be caused or aggravated by sitting with a large wallet in the affected side’s rear pocket.

My tri-fold wallet is pretty fat. I did a cleanout last night.  One and a half inches thick. Contents:  22 money bills (too many $1 bills for anyone not planning to go to a go-go bar),  6 credit cards,  12 ID type cards (driver’s license, library, work ID, Costco, AAA, Dunkin Donuts), 5 business cards, 5 folded paper notes (my wife’s sizes for shopping, directions, a poem) – but I find it hard to lose any of it except by replacing the bills with a few $20 dollar bills (which will turn into singles again anyway).

Okay, so what’s my other home treatment?

You might find some quick relief by walking with the foot on the involved side pointing outward which externally rotates the hip, lessening the stretch on the piriformis and relieving the pain slightly. That’s a goofy non-cure, but if it works, I guess you do have the syndrome.

Runners, bicyclists and other athletic types who have it need to do lateral stretching and strengthening exercises. When not balanced by lateral movement of the legs, repeated forward movements can lead to disproportionately weak hip abductors and tight adductors. When piriformis syndrome is caused by weak abductors combined with tight adductors, a highly effective and easy treatment includes stretching and strengthening these muscle groups. An exercise regimen targeting the gluteus medius and hip adductor muscle groups can alleviate symptoms of piriformis syndrome within days. What exercises are those? I have no idea. Start Googling or ask that guy at the gym.

my problematic contents

Guys, are you feeling any tingling and numbness in the groin and saddle areas? How about urinary and fecal incontinence?

It hits me on longer car trips and I noticed that I have to take out my wallet from my right rear pocket where it has been my whole life.

Now, Doctor Ken is not telling you that this is definitely the cause of your numb ass. Maybe you just sit on it too much. Maybe it’s some other more serious thing like “stiffness, or hypomobility, of the sacroiliac joints” or “overpronation of the foot” and you better go see a doctor with a medical degree. I’m suggesting that you do a wallet cleanout and consider moving that wallet from the back pocket.

In that radio interview, Michael Chabon started carrying a diaper bag because of his kids and the wallet ended up there. A semi-acceptable handbag.  If it’s thin enough, can I get away with a wallet in the front pocket? I don’t wear suits or sport coats enough to use that as a solution. Suggestions welcome.