Traditional yogurt is made by introducing “live cultures,” aka bacteria, to milk so they can convert the lactose, or sugars, into lactic acid, explains Janette Marsac, RDN, LCSW, a New York City-based registered dietitian nutritionist. It’s unstrained, and can be made from skim, low-fat, or whole milk. Since it’s not strained of excess liquid, traditional yogurt tends to have a milkier, thinner texture than strained yogurts like Greek or Icelandic versions.
Greek Yogurt
Greek yogurt is made by straining the traditional kind to remove whey, which makes it thicker and leaves a higher concentration of some nutrients. It typically has twice as much protein (around 15 g) as regular yogurt, says Carrie Lam, MD, with the Lam Clinic of Integrative Medicine in Tustin, California. However, Greek yogurt is lower in calcium than traditional yogurt. Per 8 ounces (oz), it supplies 27 percent of the Daily Value, versus traditional yogurt’s 45 percent.
Greek yogurt also strains the majority of lactose from the cow’s milk, leaving a thick, creamy texture behind that’s easier to digest than some other kinds. Greek yogurt can be made from nonfat, low-fat, or whole milk.
Icelandic Yogurt
Also known as skyr, this traditional Icelandic fermented dairy product straddles the line between cheese and yogurt. It’s strained more than Greek yogurt, so it’s thicker and even more protein-packed, with around 20 g per cup, and little added fat or sugar. Traditionally, skyr is made with skim milk.
Its taste is often described as milder than Greek yogurt, and it has naturally low levels of sugar and lactose, says Diana Gariglio-Clelland, RD, CDCES, a Washington state–based registered dietitian with Next Luxury. You can find Icelandic yogurt in the United States marketed under brands such as Siggi’s and Icelandic Provisions.
Australian Yogurt
This unstrained yogurt tends to be creamy and rich, like a high-protein dessert. It’s made with skim milk and cream (or sometimes simply whole milk), and is cooked slower and longer than other yogurts. The brand Wallaby says that Australian yogurt’s smooth texture and mild taste are the result of a slow culturing process.
Noosa Yoghurt, another brand made (and spelled) in the Australian style, contains 150 calories per 4.5 oz, depending on the flavor. Because these tend to be sweeter and have less protein, they’re a good option for a healthier dessert.
French Yogurt
This style is made by a technique known as “pot set,” in which whole milk and live cultures are combined in individual pots and left to ferment for up to eight hours. French yogurt is not strained, so it retains some of its sweetness (and lactose), but is thicker than other unstrained yogurts, like Australian. French yogurt pots tend to be slightly smaller than other varieties, and so may have the advantage of built-in portion control. Several flavors from Oui by Yoplait, for instance, are 170 calories per 5-oz pot.
Beth Biggee, MD, is medical director and an integrative rheumatologist at Rheumission, a virtual integrative rheumatology practice for people residing in California and Pennsylvania. This first-of-its-kind company offers whole person autoimmune care by a team of integrative rheumatologists, lifestyle medicine practitioners, autoimmune dietitians, psychologists, and care coordinators.
Dr. Biggee also works as a healthcare wellness consultant for Synergy Wellness Center in Hudson, Massachusetts. Teamed with Synergy, she provides in-person lifestyle medicine and holistic consults, and contributes to employee workplace wellness programs. She has over 20 years of experience in rheumatology and holds board certifications in rheumatology and integrative and lifestyle medicine. Dr. Biggee brings a human-centered approach to wellness rather than focusing solely on diseases.
Dr. Biggee graduated cum laude with a bachelor’s degree from Canisius College, and graduated magna cum laude and as valedictorian from SUNY Health Science Center at Syracuse Medical School. She completed her internship and residency in internal medicine at Yale New Haven Hospital, completed her fellowship in rheumatology at Tufts–New England Medical Center, and completed training in integrative rheumatology at the University of Arizona Andrew Weil Center for Integrative Medicine. Following her training, she attained board certification in rheumatology and internal medicine through the American Board of Internal Medicine, attained board certification in integrative medicine through the American Board of Physician Specialties, and attained accreditation as a certified lifestyle medicine physician through the American College of Lifestyle Medicine. She is certified in Helms auricular acupuncture and is currently completing coursework for the Aloha Ayurveda integrative medicine course for physicians.
In prior roles, Dr. Biggee taught as an assistant clinical professor of medicine at Mary Imogene Bassett Hospital (an affiliate of Columbia University). She was also clinical associate of medicine at Tufts University School of Medicine and instructed “introduction to clinical medicine” for medical students at Tufts. She was preceptor for the Lawrence General Hospital Family Medicine Residency.
Dr. Biggee has published in Annals of Rheumatic Diseases, Arthritis in Rheumatism, Current Opinions in Rheumatology, Journal for Musculoskeletal Medicine, Medicine and Health Rhode Island, and Field Guide to Internal Medicine.
Even though pregnancy puts you at higher risk for DVT, you can take steps to protect yourself from blood clots. Above all, talk to your provider about your symptoms as much as you need to. When it comes to protecting yourself from DVT, no question is too small.
Be Aware of Your Risk Factors
The more prepared you are, the better you can prevent DVT in pregnancy. Ask the women in your family if they have had blood clots, and notify your provider of any family history or other risk factors.
Keep Moving
Lack of movement can affect your blood flow and increase your risk for DVT in pregnancy, says Dr. Berens. “So stay active and maintain a healthy weight.” If you have to be on bed rest because of an injury or complication in your pregnancy, your doctor may prescribe blood thinners as a precautionary measure.
Get Up During Travel
“Flying in itself is a risk factor for DVT, so pregnant women who fly are definitely at an increased risk,” Berens says. If you have to fly, get up and move around every hour or two and do ankle roll exercises while you sit. “Do the same thing if you go on a long car or bus ride,” she adds.
Wear Compression Socks
Because they improve circulation and reduce swelling in the legs, compression socks can lower your risk of DVT in pregnancy, Roshan says.
Drink Lots of Water
Good hydration during pregnancy helps prevent clots by keeping the blood from getting too thick, Roshan says. Experts recommend that pregnant women drink 8 to 12 glasses of water every day.
Use Prescribed Medication
If you have a DVT, you will probably be treated with a blood thinner like enoxaparin (Lovenox), which is safe during pregnancy. “We treat the clot with a therapeutic dose for a few months and then lower it to a prophylactic (preventive) dose,” says Roshan.
If your provider prescribes medication for you, it’s very important you take it as instructed. If you’re not sure how to take it, or have questions about it, let your provider know right away.
“We usually monitor women taking blood thinners throughout their pregnancies because as the pregnancy progresses, they sometimes need higher doses,” Roshan says. “For women with a family history of DVT but no personal past history, we sometimes prescribe baby aspirin and tell them to be particularly cautious about symptoms.”
Overall, erring on the side of caution with blood clots can help prevent or catch any potential complications early. “Deep vein thrombosis in pregnancy can be life-threatening, so if you see any signs, don’t hesitate to go to your doctor to get checked,” Roshan says.
An A1C test, also known as a hemoglobin A1C or HbA1C test, is a simple blood test that estimates your average blood sugar levels over the last three months. People who don’t have diabetes may be given this test at a wellness visit to screen for prediabetes or diabetes. People who have diabetes may use an A1C test to monitor how well their disease is being managed.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291b44ab7c-c0e3-4d99-a769-d0953c8b89cd
Who Typically Needs an A1C Test? Who Needs an A1C Test? A1C tests are performed routinely on people with and without diabetes. People With Diabetes If you already have diabetes, your initial diagnosis may have been given based on the results of an A1C test. Regular A1C tests are also one of the most important health markers for people with diabetes after a diagnosis. Measuring A1C levels is perhaps the best tool your healthcare providers have for monitoring the progression of your diabetes and the success of your treatment. Your A1C measurement gives a clinician or diabetes educator a single snapshot of how high or low your blood sugar levels have been over the past several months. Your A1C results will help determine whether your diabetes management plan — including diet, exercise, medication, and other lifestyle changes — needs adjustment. Most people with diabetes are advised to get new A1C checks every three to six months.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297e3c2371-3d81-4840-a637-5472e3924dcd People Without Diabetes An A1C test is also one of the most common and reliable ways of diagnosing prediabetes and diabetes:e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2baa345-ed0b-4a51-8950-1c5eea4ca717
If your A1C result is in the diabetic or prediabetic range, your clinician may choose to administer another test, such as a fasting blood glucose test or an oral glucose tolerance test, to confirm your diagnosis. If you are experiencing some of the symptoms of high blood sugar — such as frequent urination, intense thirst, or blurry vision — your doctor may give you an A1C test to check for diabetes. Others will receive an A1C test as a matter of routine during a checkup or wellness visit. And some healthcare professionals will choose to screen adults with certain risk factors for diabetes. The U.S. Preventive Services Task Force recommends diabetes screening for all adults over the age of 35 who are overweight or who have obesity, and it suggests that doctors screen people at an even earlier age if they have one of the following additional risks:e60dc2a1-f33c-4a05-9b50-8e3e8e5976298162fcd1-5d51-4e28-a8a1-307d235b9c92 A family history of diabetes A personal history of gestational diabetes Polycystic ovary syndrome
How Is an A1C Test Performed? How It’s Performed An A1C test uses a simple blood sample and doesn’t require any special preparation. During an office visit, a nurse or phlebotomist will take a blood sample from a vein or finger and send it to a lab to be analyzed.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293eddf7bd-22c9-4e53-9544-2396860a523c An A1C test doesn’t require fasting. You can eat and drink normally prior to the test, unlike with a fasting glucose or cholesterol test, and the results will not be significantly affected if your blood sugar happens to be unusually high or low at the time of the test.e60dc2a1-f33c-4a05-9b50-8e3e8e59762905f973bc-26f6-4f81-bd9a-84fe5698fbcb Blood tests pose very little risk. It’s possible that there may be some bruising or soreness in the area where the needle was inserted, but it typically goes away quickly. You may also want to avoid lifting heavy objects for 24 hours after the test.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294c318ef5-b3b5-4a66-af44-c2a764f26203 It is also possible to purchase an at-home A1C test, although these products are probably less reliable than a test conducted by a certified laboratory.e60dc2a1-f33c-4a05-9b50-8e3e8e59762945f42bbe-06a3-47f6-9b05-d0b30e60e46d
What Do My A1C Results Mean? Results A1C results are reported as a percentage in the United States. To find your average blood sugar level over the past several months, you can convert the number into the same measurement that your blood sugar meter or continuous glucose monitor uses:e60dc2a1-f33c-4a05-9b50-8e3e8e59762995024c4d-82b0-48c0-8f61-68d792eef3d2
Some lab reports will also list this second number, which may be labeled “estimated average blood glucose (eAG).” In many other countries, A1C and blood sugar measurements are given in different units.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294eacd01e-63a4-4462-8d2c-049e57f0c1a3
What’s Next? What’s Next Your A1C test results will help a clinician to determine the recent history of your blood sugar levels, which are an important aspect of your metabolic and overall health. If you’ve never been diagnosed with prediabetes or diabetes, the results of your A1C test will help your healthcare provider determine whether you have either of those conditions, or it could indicate that you are at risk of developing them in the future. You may be asked to try to lose weight, change your diet or exercise habits, or take a new medication. If you have already been diagnosed with diabetes, your A1C result will help determine how well your treatment has been working. High A1C results, which indicate that your blood sugar has been chronically elevated above a healthy range, are strongly correlated with the complications of diabetes , including vision loss, nerve damage, kidney failure, and cardiovascular disease. People with diabetes who can keep their A1C below 7 percent, the target set for most nonpregnant adults by American health authorities, have a significantly reduced risk of diabetic complications.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296cbcb6c7-7516-4284-9e28-7913470ec85be60dc2a1-f33c-4a05-9b50-8e3e8e597629370de45b-d73a-4154-b296-c1017662b0fc If your A1C result is above the target set by your healthcare provider, you may be asked to increase your diabetes management efforts. This could include making new changes to your diet and exercise habits or to how frequently you check your blood sugar. You may also be prescribed new diabetes medications or larger doses of your existing medications.
The Takeaway The A1C test measures average blood sugar levels over the past three months and is an essential part of diagnosing and managing diabetes. An A1C test uses a standard blood draw, and it doesn’t require any special preparation or recovery. It is recommended that most adults with diabetes keep their A1C below 7 percent; higher numbers are associated with a greater risk of diabetes complications. Your healthcare provider should use your A1C results to make recommendations about the way you manage your diabetes or prediabetes, including changes to your medication or your diet, exercise, and lifestyle habits.
Resources We Trust Cleveland Clinic: How to Reverse Prediabetes Mayo Clinic: Diabetes Management: How Lifestyle, Daily Routine Affect Blood Sugar Mass General Brigham: How to Control Blood Sugar With Diet American Diabetes Association: Understanding Your A1C Test Centers for Disease Control and Prevention: Diabetes Testing
Is your phone your constant companion, all the way through bedtime? It might be messing with your sleep. A new study from Norway found that more screen time in bed significantly raised the likelihood of insomnia.
Specifically, an hour of in-bed screen time increased insomnia risk by nearly 60 percent, and lowered sleep duration by about a half hour.
“We were particularly interested in whether social media — because of its interactive and potentially emotionally stimulating nature — would have a stronger association with poor sleep outcomes than other screen activities,” says the study author Børge Sivertsen, PhD, a senior researcher at the Norwegian Institute of Public Health in Bergen.
“Surprisingly, we found that it’s the overall screen time in bed that matters most, not the type of activity,” Dr. Sivertsen says.
Sleep Troubles Grow as Screen Time Increases
Sivertsen and his colleagues analyzed survey responses from more than 45,000 adults ages 18 to 28.
Participants were asked whether they used screens after going to bed, for how long, and for how many nights per week. Then they identified their common screen activities: watching shows or movies, gaming, social media, surfing the internet, listening to audio such as podcasts, or reading.
The survey also asked when participants typically went to bed, when they got up in the morning, and how long it typically took them to fall asleep. Participants indicated how often they had trouble falling or staying asleep, how often they felt sleepy during the day, and how long their sleep problems persisted.
Insomnia was defined as having trouble sleeping and experiencing daytime sleepiness issues at least three times a week for at least three months.
The results showed that a one-hour increase in screen time in bed was linked to a 59 percent greater risk of insomnia and 24 fewer minutes of total sleep on average.
Sivertsen stresses that insomnia symptoms and reduced sleep duration were associated with an increased amount of screen use.
He adds that the findings are limited in that they are observational, relying on preexisting self-reported data from a narrow population (young adult Norwegians) that did not include scientific sleep measurements.
Why You Should Avoid Your Phone Before Bed
Many health authorities, including the Sleep Foundation, recommend avoiding computers and smartphones entirely in the hour leading up to bedtime.
“Screen time at bedtime activates the mind,” says Vishesh Kapur, MD, MPH, the director of sleep medicine at the University of Washington in Seattle, who was not involved in the study. “If the individual is consuming content that is very interesting, they may delay going to sleep, or if the content is disturbing or anxiety-inducing, this could make it hard to fall asleep.”
Blue light from screens may also promote wakefulness. “Blue light from screens suppresses melatonin production, a hormone essential for initiating sleep,” says Nitun Verma, MD, a sleep physician and spokesperson for the American Academy of Sleep Medicine.
Tips to Break the Bedtime Screen Habit
Dr. Verma, who was not involved in the research, offers the following tips to prevent wakeful effects from smartphones and get better sleep:
Avoid screens 30 to 60 minutes before bedtime.
If you must use screens, keep brightness to a minimum.
Use built-in phone features like Night Shift, which reduces blue light, and Do Not Disturb, which silences notifications, calls, and alerts.
Replace screen time with a relaxing bedtime ritual such as reading a physical book or gentle stretching.
Consider an old-fashioned alarm clock instead of setting an alarm on your phone to reduce the temptation to go online.
“Our study shows that even small reductions [in screen time] could improve sleep quality and duration,” says Sivertsen. “It’s not about quitting screens entirely — it’s about being mindful of how and when we use them, especially at night.”
On-demand coffee machines are becoming more common in the workplace, but new research suggests that drinking coffee brewed this way could contribute to higher “bad” cholesterol levels.
The oil in coffee beans is rich in compounds called diterpenes. Decades ago, scientists found that these substances were high enough in unfiltered coffee to strongly raise “bad” LDL cholesterol and slightly reduce “good” HDL cholesterol in humans. Later research showed that diterpenes were significantly higher in unfiltered boiled and French press coffee than in paper-filtered coffee.
“Coffee from workplace machines, however, had not been examined until now,” says study author David Iggman, PhD, a researcher at Uppsala University in Sweden. “We found the levels of these substances are much higher in coffee from these machines than from regular drip-filter coffee makers.”
Based on their results, Dr. Iggman and colleagues estimated that replacing three cups of brewing-machine coffee with paper-filtered coffee five days per week could lower LDL cholesterol by 13 percent over five years, or 36 percent over 40 years.
Paper Filters May Make a Difference
For the analysis, the study authors measured two kinds of diterpene — cafestol and kahweol — in coffees made in 14 different types of conventional self-serve coffee makers found in break rooms and different work spaces.
Coffee samples were taken from two types of office machines:
Machines that mixed hot water with the ground coffee and then passed the liquid through a metal filter
Machines that mix a liquid coffee concentrate with hot water
For comparison, the researchers also analyzed samples of coffee made with a paper filter, a percolator, and a French press, as well as by coffee made by boiling ground beans with water (a method popular in Sweden).
In addition, they examined four espresso samples made in three cafeterias and one laboratory workplace coffee machine.
They discovered that most coffees from workplace brewing machines contain higher diterpene concentrations than paper-filtered coffee.
Ranking Brew Styles From Best to Worst
The researchers measured diterpenes in terms of milligrams per liter (mg/L). For all workplace coffee machines, the median range of cafestol and kahweol was 174 and 135 mg/L, respectively, compared with 11.5 mg/L of cafestol and 8.2 mg/L for kahweol in paper-filter drip coffee.
Diterpene concentrations in French press (87 mg/L cafestol and 69 mg/L kahweol) and percolator coffee (91 mg/L cafestol and 69 mg/L kahweol) fell in the middle between coffee machine and paper filter levels.
Boiled coffee (939 mg/L cafestol and 678 mg/L kahweol) and espresso (1,059 mg/L cafestol and 621 mg/L kahweol) had the highest diterpene content. The study authors noted, however, that there was considerable and “unexplained” variation in espresso samples with cafestol levels ranging from 35.6 to 2,446.7 mg/L.
Because espresso is made by forcing hot water through very finely ground coffee under high pressure without a filter, it makes sense that this brew has the highest potential to raise cholesterol levels.
The findings here correspond with previous research showing a significant association between espresso consumption and higher measure of bad cholesterol in the blood.
“Keeping espresso to a minimum will lower risks,” says Melissa Prest, DCN, RDN, a spokesperson for the Academy of Nutrition and Dietetics, who was not involved in the study. She recommends limiting espresso to one or two shots per day at most.
Overall, coffee brew styles ranked as follows in order of best to worst for cholesterol are:
Paper filter
Filtered boiled
French press
Workplace coffee machine
Percolator
Boiled without filtering
Espresso
Study Does Not Address the Impact on Heart Disease Risk
For Gregory Katz, MD, a cardiologist at NYU Langone Heart in New York City, these study results are limited in that experiments were not conducted to see the actual impact on LDL levels or endothelial function (the functioning of cells that line the inside of blood vessels).
“They certainly didn’t test different brewing methods and then see how that impacted things like heart attack and stroke,” says Dr. Katz. “The study tells us zero information about how this impacts the risk of cardiovascular disease.”
Coffee Has Many Health Benefits
While cafestol and kahweol in excess may raise LDL cholesterol, research suggests that these compounds may also come with benefits. “The benefits of these two substances with regular consumption of coffee includes anti-inflammatory properties and its links to reducing the risk of type 2 diabetes,” says Julia Zumpano, RD, with the Cleveland Clinic Center for Human Nutrition, who was not involved in the new study. She adds that the negative effects may be significantly lowered through filtering.
Coffee also offers the following health benefits:
Micronutrients like vitamin B2 and B3, potassium, and magnesium
Antioxidants, which protect cells from damage and may lower the risk of certain cancers
Phenols, which play key roles in immunity and protecting the body from inflammation
Caffeine, which may offer potential support for brain health, blood flow, and blood pressure.
Coffee Add-Ins May Pose a Higher Risk Than Coffee Itself
Maya Vadiveloo, PhD, RD, chair of the American Heart Association’s Lifestyle Nutrition Committee and an associate professor of nutrition and health sciences at the University of Rhode Island in Kingston, suggests that the ingredients we add to coffee may be more damaging than the coffee itself.
“Both excess added sugar and saturated fat found in high fat dairy products like cream adversely affect cardiovascular health,” says Dr. Vadiveloo, who was not involved in this study.
She advises consumers to drink coffee in moderate amounts, but filter it whenever possible to reduce the risk of elevated LDL cholesterol.
Medical IV therapy is administered by a trained healthcare professional in a hospital, medical clinic, or home. Your healthcare team (which may include doctors, nurses, nutritionists, and pharmacists) will collaborate to prescribe the cocktail of IV nutrition therapy at doses suited to your needs. Then, your healthcare provider will attach the IV bag to your catheter, a thin, flexible tube inserted into a vein using a needle that delivers IV fluids to your bloodstream. It typically takes 10 to 12 hours for the contents of the bag to fully enter your body.
Meanwhile, medical spas, integrative medicine physicians’ offices, and drip bars (wellness clinics that provide IV nutrition therapy on-site or deliver infusions to homes, offices, or hotel rooms) may offer nonmedical IV nutrition therapy. It’s often administered by a nurse or physician’s assistant. But there’s no guarantee that you’ll get a licensed medical professional, because there isn’t federal oversight on who prescribes, prepares, and administers the solution for nonmedical IV therapy.
A reputable clinic has medical oversight from a physician or a nurse practitioner. Your vitals will be checked, and you’ll be asked to complete a health screening or questionnaire before you receive IV therapy, says Steve Rallis, a doctor of chiropractic medicine, doctor of naturopathy, and the chief medical officer for the DRIPBaR Canada. Then, the IV is administered by a nurse.
The nutrient solution will be made according to your needs, Rallis says. You’ll receive a steady supply of the solution through the IV while you sit, with sessions lasting approximately 20 to 60 minutes. You should be monitored during the session, and your vitals should be rechecked once the injection is completed, Rallis says.
Many IV drip companies recommend coming once every two weeks, though this depends on the person and their reasons for going in the first place, Rallis says. Expect to go more than once. “If it’s for fatigue, as an example, you’re unlikely to see the benefit until you’ve done around six to eight IVs,” Rallis says.
Most experts agree that the best way to get omega-3 fatty acids is by eating fatty fish, which contain the highest amounts of EPA and DHA. These fish include salmon, mackerel, and trout. Fish oil supplements are not thought to be as beneficial.
“Whole fish provides additional nutrients and bioavailability advantages over supplements,” says Avena.
Dr. Yassine notes that, overall, fish oil supplementation trials have been inconclusive. “Fish is complex. Even the actual DHA and EPA in fish is not the same as what is present in supplements,” he says
For people who don’t eat fish, Avena says algal oil is the best plant-based source of DHA and EPA, as it’s derived from the same marine algae that fish consume.
Flaxseeds, chia seeds, hemp seeds, and walnuts contain alpha-linolenic acid (ALA) which can be converted into EPA and then to DHA in the body, but not very efficiently, which is why consuming marine food sources is preferable.
How Much Fish Oil Should I Take?
The 2020–2025 Dietary Guidelines for Americans recommend that adults eat 8 ounces (oz) of fish per week. The average size of a main portion fish filet is around 8 oz when raw and 6 oz when cooked (use the size of your hand as guide to portion size), so it’s best to aim for at least one serving a week or more. But even if you’re only getting one serving of fish per week, the brain may benefit.
“Research shows that when comparing people who are consuming one or more servings of fish per week to those who are eating less, fish eaters experience less cognitive decline over the years,” Dr. Agarwal says.
“That should be encouraging, because this is a simple lifestyle modification to maintain brain health,” Agarwal says.
For those who prefer supplements, Rizzo says most fish oil supplements are 1,000 milligrams (mg). There are no universal recommendations for omega-3 supplements, but the U.S. Food and Drug Administration specifies that the labels of dietary supplements should not recommend a daily intake of EPA and DHA higher than 2 grams (g).
Piriformis syndrome is a painful condition that happens when the piriformis muscle compresses or irritates the sciatic nerve, causing inflammation. It can cause pain and numbness in the buttocks area and down the back of the leg, on one side of your body or on both. The piriformis is a flat, narrow muscle that runs from the lower spine through the butt to the top of the thighs. The sciatic nerve usually runs underneath the piriformis. It’s the longest and largest nerve in the body, and it travels from the spinal cord through the buttocks and down the back of each leg to the feet. But piriformis syndrome isn’t the same as sciatica . In sciatica, the symptoms usually affect the lower back and can travel down through the buttocks and leg, whereas in piriformis syndrome, the pain is typically centered in the buttocks and may extend down the back of the leg. Generally, piriformis syndrome goes away in a few days or weeks with lifestyle adjustments and treatments. If the pain is ignored, it can get in the way of everyday activities.e60dc2a1-f33c-4a05-9b50-8e3e8e597629724b519a-b64f-4279-9f63-2436a0192c5a
Types of Piriformis Syndrome Types There are two types of piriformis syndrome, primary and secondary. Primary piriformis syndrome is caused by abnormal muscle or nerve anatomy.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a0b74f14-9ab1-4bfa-a0ba-4e97bb47c8ff Secondary piriformis syndrome can be triggered by such things as a traumatic injury to the buttocks, overuse of the piriformis muscle in athletes, prolonged sitting, leg length discrepancy, and intramuscular gluteal injections, a shot deep into the butt muscles. It may also result from conditions that cause muscle tightness, like hip arthritis. More than 85 percent of people with the condition are estimated to have secondary piriformis syndrome — which is usually just called piriformis syndrome.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293765672e-98eb-40c5-99f2-c66400aae401
Signs and Symptoms of Piriformis Syndrome Symptoms Symptoms can occur in the buttocks, hips, or upper legs. It can feel like: Pain in the buttocks, often radiating down the back of the leg Burning, numbness, or a tingling sensation along the sciatic nerve path Pain that worsens with prolonged sitting, walking, running, and stair climbinge60dc2a1-f33c-4a05-9b50-8e3e8e59762981c58a57-ecb5-445d-b024-da4ec7acafba Pain when getting out of bede60dc2a1-f33c-4a05-9b50-8e3e8e5976299ffcded9-9750-4392-bfc4-a5e546f7720f
Causes and Risk Factors of Piriformis Syndrome Causes Causes of piriformis syndrome can include: Injury or trauma: A fall or direct injury to the buttocks can damage the piriformis muscle or irritate the sciatic nerve. Not stretching or warming up: Warming up before exercise helps to supply your muscles with blood and oxygen so they’re ready for activity. Tight muscles from lack of physical activity Lifting something heavy without good form Prolonged sitting: Sitting for extended periods , especially with poor posture, or sitting with a thick wallet in a back pocket directly behind the piriformis muscle can contribute to piriformis syndrome. Overexercise: Repetitive motions and activities like ultramarathons can lead to piriformis syndrome. Anatomical variations: In primary piriformis syndrome, a person may have anatomical variations where the sciatic nerve passes through the piriformis muscle instead of underneath it, making it more prone to irritation. Abnormal spine alignment (such as scoliosis) and leg-length discrepancy (where legs are different lengths) can also cause piriformis syndrome.e60dc2a1-f33c-4a05-9b50-8e3e8e59762941e8a626-bb30-4799-a370-1c153ff0ac05
How Is Piriformis Syndrome Diagnosed? Diagnosis Diagnosing piriformis syndrome is based on symptoms and a physical exam. The healthcare provider will likely ask you questions about your medical history, symptoms, and activity level. They may ask you to move your leg and hip, or they may manually stretch, rotate, and press on your hip, butt, and leg to see what causes pain and what doesn’t.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d099ba8b-0d29-4baa-b237-a19c3e34c990 Common Diagnostic Procedures There isn’t any one test to confirm a diagnosis of piriformis syndrome, but there are tests that may be used to pinpoint what is causing the pain, including: MRI or CT scan Electromyography (EMG) Ultrasound These tests are mostly useful to exclude other conditions, such as a herniated disc in the lower back.e60dc2a1-f33c-4a05-9b50-8e3e8e59762992e29d88-af67-4ce4-a121-a99c2d23fc7b
Treatment and Medication Options for Piriformis Syndrome Treatment Treatment for piriformis syndrome often starts with noninvasive methods and may include a combination of physical therapy, medication, and lifestyle changes. Medication Options Medications, given as pills or injections, are used to relieve pain from piriformis syndrome. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Over-the-counter pain relievers like ibuprofen or naproxen can help reduce inflammation and pain in the shorter term. Muscle Relaxants Medications like cyclobenzaprine can help relieve muscle spasms and tension. Corticosteroid Injections For more severe cases, a healthcare provider may recommend corticosteroid injections directly into the piriformis muscle to reduce inflammation.e60dc2a1-f33c-4a05-9b50-8e3e8e59762997c8e93f-8e7e-4123-9602-484542e804b1 Anesthetic Injections Local anesthetics such as lidocaine or bupivacaine may also be injected into the piriformis muscle for pain relief.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c2f25425-7d55-4282-912f-7b39e10dd706 Botulinum Toxin Injections Similarly, botulinum toxin injections into the piriformis muscle can relieve pain. Research suggests that the median time spent pain-free after a botulinum toxin injection was about one month, which is significantly longer than the time spent pain-free after corticosteroid or anesthetic injections.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298217b16f-64bf-4d3e-a05a-b4f2781fb4be Physical Therapy While drugs or injections are sometimes necessary to manage symptoms, the mainstay of treatment for piriformis syndrome is physical therapy (PT), exercise, and stretching. Specific treatments may include the following: Adjustments in gait (the way a person walks) Improved mobility of sacroiliac joints, the points where the spine and pelvis connect Stretching to relieve tight piriformis muscles and those surrounding the hip Strengthening of the hip abductors (muscles that move the hips outward from the body) Soft tissue mobilization and myofascial release to help reduce muscle paine60dc2a1-f33c-4a05-9b50-8e3e8e59762909ac7f79-573a-4aa9-8c15-de1d2b32ed4e In addition to in-office appointments, the PT will likely provide instructions on stretching and strengthening exercises to do at home.e60dc2a1-f33c-4a05-9b50-8e3e8e59762992691079-9d83-4c65-9321-119875b3e3a2 Surgery Surgery for piriformis syndrome is typically considered a last resort when all other treatment options fail. The procedure involves removing scar tissue, a portion of the piriformis muscle, or its tendon to relieve pressure on the sciatic nerve. Results after surgery aren’t always positive, and some people continue to have pain.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293805603f-144f-41c4-95fc-c03a226c1100 Complementary Therapies Several complementary therapies can provide relief from symptoms, including: Massage therapy : Targeted massage techniques can help relieve muscle tightness and alleviate pain.e60dc2a1-f33c-4a05-9b50-8e3e8e59762997c8e93f-8e7e-4123-9602-484542e804b1 Dry needling: In dry needling, a needle is inserted into a trigger point (a tight band or knot in a muscle fiber) to relieve tightness. There are case reports of piriformis syndrome symptoms improving after 10 days of treatment with ultrasound-guided dry-needling.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299cffe76c-ca24-4ca6-ad31-813566c83285 Acupuncture: There is evidence that acupuncture can be an effective treatment for piriformis syndrome, though more research is needed to determine the safest and most effective acupuncture methods.e60dc2a1-f33c-4a05-9b50-8e3e8e59762933055f67-8f2e-4df6-a60d-330e9e171400 Ice or heat: Cold packs or a heating pad may improve pain — you can try both to see what works best for your symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e59762997c8e93f-8e7e-4123-9602-484542e804b1
Prevention of Piriformis Syndrome Prevention While it may not always be preventable, certain lifestyle changes can help reduce the risk of developing piriformis syndrome. Exercise regularly. Physical activity and twice-weekly resistance training can keep your muscles strong and healthy. Practice good posture . When sitting, make sure your spine is supported and your feet either touch the floor or rest on a footrest. Practice safe lifting . Lift things properly by bending your knees and squatting, making sure to keep your back straight. Don’t twist while lifting. Avoid prolonged sitting . Take regular breaks to stand or walk if you sit for long periods, especially if you have a desk job or drive for hours at a time. Avoid activities that trigger piriformis syndrome. If certain activities trigger piriformis syndrome — for example, running or biking — find another way to exercise, at least for a few days. Stretch . Perform regular stretching exercises, especially after exercise, to maintain flexibility and reduce muscle tightness in the hips and buttocks. For example, lie on your back, then pull one knee toward your chest. Hold for 30 seconds, then change legs. Another way to stretch without lying down is to stand, hinge at your hips and let your head and hands fall toward the floor.e60dc2a1-f33c-4a05-9b50-8e3e8e597629866f8206-244d-4192-8f83-79423206c4a7
How Long Does Piriformis Syndrome Last? Prognosis and Outlook For most people with piriformis syndrome, the prognosis is very good. Typically, symptoms improve within a few weeks with conservative treatments like physical therapy, lifestyle changes, and over-the-counter pain medications. The condition can come and go, especially in people who don’t make recommended lifestyle changes.e60dc2a1-f33c-4a05-9b50-8e3e8e59762934c38768-852a-492d-b0ae-474296d5a02f
When to See a Doctor for Piriformis Syndrome When to See a Doctor While piriformis syndrome isn’t a medical emergency, you should contact your healthcare provider if you experience any of the following symptoms: Frequent trips or falls due to pain or numbness Pain that continues longer than a few weeks after you make lifestyle changes Problems controlling your bladder or bowels (urinary or fecal incontinence) Sudden weakness or numbness in your back or leg Sudden, severe pain in your lower back or leg Trouble picking your foot off the floore60dc2a1-f33c-4a05-9b50-8e3e8e597629985b1828-90d0-4a02-a5c7-2be3b267d56a
Research and Statistics: How Many People Have Piriformis Syndrome? Research and Statistics Piriformis syndrome most commonly occurs in women and middle-aged people. It’s estimated that between 0.3 and 6 percent of low back pain or what is thought to be sciatica may be caused by the condition, with an annual incidence of about 2.4 million cases.e60dc2a1-f33c-4a05-9b50-8e3e8e59762937f9089f-795a-4727-ace2-0e06eaeee866
Conditions Related to Piriformis Syndrome Related Conditions Piriformis syndrome may be related to or occur alongside other conditions, including: Sciatica A common condition in which the sciatic nerve is irritated, it often mimics the symptoms of piriformis syndrome but in a larger area that can include the low back, buttocks, and legs. Herniated Disc When bulging or ruptured discs in the spine press on the nerves, the result can be pain that radiates down the leg. Hip Arthritis Inflammation in the hip joint may contribute to muscle tightness or misalignment that exacerbates piriformis syndrome.
The Takeaway Piriformis syndrome occurs when the piriformis muscle compresses the sciatic nerve, leading to pain, numbness, and tingling in the buttocks and legs. It can be caused by muscle overuse, trauma, anatomical variations, or prolonged sitting. Treatment options include physical therapy, medication, and as a last resort, surgery. Most cases improve with conservative care. Early diagnosis, treatment, and lifestyle changes can help prevent the condition from becoming chronic.
Resources We Trust Cleveland Clinic: Piriformis SyndromeHarvard Health Publishing: Ask Dr. Rob About Piriformis SyndromeMayo Clinic: Back Exercises in 15 Minutes a DayUCLA Health: Ergonomics for Prolonged SittingCleveland Clinic: 7 Best Exercises and Stretches for Piriformis Syndrome
Worried about the increasing presence of microplastics in our environment? Here’s something else to think about: Scientists have found that chewing just one piece of gum can release hundreds to thousands of tiny plastic pieces into our saliva that are likely to be absorbed into our bodies when we swallow, according to unpublished research that will be presented at the American Chemical Society’s Spring 2025 meeting in San Diego.
“Our goal is not to alarm anybody,” said the senior author, Sanjay Mohanty, PhD, an associate professor of civil and environmental engineering at UCLA, in a press release. “Scientists don’t know if microplastics are unsafe to us or not. There are no human trials. But we know we are exposed to plastics in everyday life, and that’s what we wanted to examine here.”
While it’s true that there’s still more to learn about the health effects of microplastic exposure, ingestion of plastics is “probably not a good thing,” says Linda Kahn, PhD, MPH, an assistant professor of population health at the NYU Grossman School of Medicine in New York City.
“What we know about microplastics themselves leads us to believe that they could be associated with negative health outcomes,” says Dr. Kahn.
Research has shown that microplastics can accumulate in our bodies, and they’ve been linked to health issues such as lung cancer, respiratory issues, decreased fertility, and reduced birth weight. But population studies can only show associations and not direct causation.
Study Subject Chewed Each Piece of Gum for 4 or 20 Minutes
To find out more about microplastics and chewing gum, scientists analyzed 10 popular chewing gum brands, five natural and five synthetic.
Chewing gums are made from a rubber base, sweetener, flavorings, and other ingredients. In general, natural gums use plant-based polymers (sometimes called bioplastics) and synthetic gums use petroleum-based polymers — in other words, gum contains plastic as an ingredient.
Researchers theorized that the synthetic gums would shed more microplastics, according to lead author Lisa Lowe, a PhD student who started the project as an undergraduate intern at UCLA.
For the first experiment, one volunteer chewed seven pieces of gum from each brand. The subject chewed each piece of gum for 4 minutes, producing samples of saliva every 30 seconds, then did a final mouth rinse with clean water, all of which got combined into a single sample.
In another experiment, the volunteer provided saliva samples periodically over 20 minutes of chewing gum, so researchers could look at the release rate of microplastics from each piece.
Key findings from the experiment included:
Gum released an average of 100 microplastics per gram (g). Gum is usually between 2 and 6 g. For example, one piece of Extra brand gum weighs 2.5 g.
Some types of gum released up to 637 microplastics per gram.
Most of the microplastics detached from gum within the first 2 minutes of chewing. It wasn’t saliva that broke down the microplastics, but rather the act of chewing that made the pieces flake off.
Surprisingly, both synthetic and natural gums released similar amounts of microplastics.
Researchers estimated that if the average person chewed 160 to 180 small sticks of gum per year, they would ingest around 30,000 pieces of microplastic.
How does microplastic exposure from chewing a piece of gum compare with exposure from plastic water bottles or plastic food storage containers? “This is hard to compare, because our study was limited by our analysis instruments,” says Lowe.
The technology researchers used could only identify microplastics 20 micrometers wide or larger — they couldn’t assess the smaller, nano-size plastics. That means their microplastic counts are likely underestimates, the study authors say.
Goodbye to Gum?
“I don’t think it is very critical that we don’t chew gum. There are so many places we are exposed to microplastics, and we can’t avoid them all. But I think it is important to be aware of this issue,” says Lowe.
If people want to continue to chew gum but limit their microplastic exposure, she suggests chewing one piece longer rather than popping in a new piece.
Because the research hasn’t been published yet, there are some unanswered questions, says Kahn. “If natural and synthetic gum both release microplastics, what is the source? The gum itself or the packaging?”
It would also be helpful to know if one type of gum is higher in microplastics, for example bubble gum or sugar-free gum, she says.
Kahn leans toward limiting gum. “It can’t hurt to be cautious,” she says. “If gum chewing is a source of microplastics, then it probably is not a great thing to do if you can avoid it, right?”
