Piriformis Syndrome

Piriformis syndrome results from compression of the sciatic nerve as it runs past the piriformis muscle at the back of the hip.  Your piriformis muscle attaches the sacral bone at the lowest part of the spine.  The muscle helps to rotate your leg outward when it contracts.  In most people, the sciatic nerve travels deep to the piriformis muscle. Yet, when your piriformis muscle is irritated or goes into spasm, it may cause a painful compression of your sciatic nerve.  Approximately ¼ of the population is more likely to suffer from piriformis syndrome because their sciatic nerve actually passes through the muscle.

Piriformis syndrome is also referred to as “deep gluteal syndrome”. The medical literature first described the syndrome in 1928. Technically, piriformis syndrome is compression of the proximal sciatic nerve by a hypertonic piriformis muscle. Some researchers estimate that piriformis syndrome contributes to up to one third of all back -related pain.  In general, mechanical back pain and hip pain frequently go together.

piriformis syndrome

How does the syndrome start?

Piriformis syndrome can develop suddenly is result of an injury, or it may develop slowly over time.  Comment sudden causes include: falling onto the back of the hip, slipping and straining a muscle in the hip, long-distance walking, or sitting on the edge of a hard surface.  Yet in many cases, one cannot pin piriformis syndrome on a specific event.  The condition is most common between 40 and 60 years old.  Women are more effective because of differences in hip architecture from their male counterparts.

Symptoms of piriformis syndrome.

Symptoms of piriformis syndrome include pain, numbness, and/or tingling.  These symptoms begin in the buttock and radiate along the course of the sciatic nerve running down the back of the leg and into the foot.  Symptoms usually increase when one sits or stands still for more than 15 minutes. Changing positions or moving around may help. Additionally, symptoms can increase with walking, running, climbing stairs, or getting up from a chair.

The piriformis muscle is a stabilizer of the hip, also contributing to hip rotation. For most people, the sciatic nerve runs deep to the piriformis muscle. Yet, approximately one quarter of the population has a sciatic nerve that runs through the piriformis muscle. This may be predisposing to piriformis syndrome. The sciatic nerve gives sensation to the lower leg and foot. As such, individuals may have nerve symptoms of burning, tingling, or numbness at the leg and foot and infrequently the back of the thigh.  Buttock pain occurs because of spasm of the muscle.

Treatment of sciatica from piriformis syndrome.

Irritation of the sciatic nerve by the piriformis muscle responds well to conservative treatment at this office. It may be important to limit certain activities for a while. Activities that cause the piriformis muscle to become sensitive should be limited during treatment and throughout recovery. Home stretching and strengthening exercises are important to treat piriformis syndrome and later preventing it from becoming a repeated issue.  Your doctor of chiropractic can help you meet your goals regarding treatment and prevention.

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