What is Piriformis Syndrome?
The piriformis muscle is a flat, band-like muscle located in the buttocks near the top of the hip joint. This muscle is important in lower body movement since it stabilizes the hip joint and lifts and rotates the thigh away from the body. This enables us to walk, shift our weight from one foot to another, and maintain balance. The sciatic nerve is a thick and long nerve in the body. It passes alongside or goes through the piriformis muscle, down the back of the leg, and eventually branches off into smaller nerves that end in the feet.
Piriformis syndrome can cause another condition, called sciatica.
The exact causes for this syndrome are unknown. However, suspected causes include:
- Muscle spasm in the piriformis muscle, either because of irritation in the piriformis muscle itself, or irritation of a nearby structure
- Tightening of the muscle, in response to injury or spasm
- Swelling of the piriformis muscle, due to injury or spasm
- Bleeding in the area of the piriformis muscle.
Symptoms include a dull pain in the buttocks, pain which may extend down the back of the thighs, calf and foot. Also, hip movements can be painful. The pain may be aggravated after prolonged sitting.
There are no definitive tests for piriformis syndrome. Your doctor may ask if there is a history of trauma to the area, or if you engage in repetitive, vigorous activity such as long-distance running, or prolonged sitting. Diagnosis of piriformis syndrome is done by a physical examination using a variety of movements to elicit pain in the piriformis muscle. Typically, any motion of the hip will recreate the pain. The exam will also identify or rule out other possible causes of the sciatica pain, such as testing for local tenderness and muscle strength. Because symptoms can be similar in other conditions, radiologic tests such as MRIs may be required to rule out other causes of sciatic nerve compression, such as a herniated disc.
Piriformis Syndrome is usually treated through physiotherapy.
- Your physiotherapist may suggest few of the exercises that stretch your piriformis muscles and/or hamstrings. These exercises aim to improve the range of motion of the hip and reduce the pain;
- Massages also help in healing as they increase the blood flow to the area and decrease the spasm;
- Depending on the intensity of pain, ice or heat application may be done by your physiotherapist;
- Local anesthetic and corticosteroid injections have also found to be helpful in reducing the pain;
- For some cases, medications may be prescribed by the doctor to relieve pain and inflammation;
- Surgery for this syndrome is uncommon and only done in extreme pain or continuous spasm.
This is one condition that can be prevented by taking certain measures. Doctors suggest warming up thoroughly before starting any physical exercise help you keep your body healthy and away from any shortcomings, and to gradually increase the intensity. Also, having a good posture while running and exercising helps in preventing this syndrome. To know more on treating Piriformis Syndrome, contact your nearest Physiotherapist.