Piriformis Syndrome

What is Piriformis Syndrome

Most of you may have heard of sciatica, but the term piriformis-syndrome is still uncommon. It is a neuromuscular disorder arising from the contraction or compression of the piriformis muscle on the sciatica nerve. The piriformis is a flat and band-like muscle. It is present in the buttocks near the apex of the hip joint. 

The piriformis muscle is vital for all types of lower-body movements. It stabilizes the hip joint and helps in lifting or rotating the thigh away from your body. In fact, piriformis muscles help you walk, maintain body balance, and shift your weight from one foot to another. If you are an athlete, the muscle has a crucial role in the rotation and lifting of the thighs. Basically, every movement involving the hips and legs is under the control of the piriformis muscle.  

The thick sciatica nerve passing alongside the piriformis muscle sometimes also goes through it. And the nerve then goes down along the back of your legs to eventually branch off into smaller nerve endings in the feet. Spasms of the piriformis muscle can cause nerve compression.

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It is a neuromuscular disorder arising from the contraction or compression of the piriformis muscle on the sciatica nerve.

Symptoms of piriformis-syndrome:

Sciatica is the chief symptom of piriformis-syndrome. However, there are many associated symptoms of the syndrome. You may feel pain and discomfort in some other part of your body. The medical terminology for such pain is "referred pain." 

The other common symptoms include: 

  • Tenderness in the muscles of the buttocks.
  • Pain when you sit, and the pain gets worse the longer you sit.
  • Tingling sensation or numbness in the buttocks that can extend down the back of the leg. 
  • Difficulty in sitting comfortably.
  • Continuous pain in the legs and buttocks that worsens with activities. 
  • Severe pain while attempting particular movements like climbing stairs, running, or walking. 

Causes of Piriformis Syndrome: 

The piriformis muscle is working out most of the time as you walk or turn the lower body. The muscle is active even when you are slightly shifting the body weight from one side to another. But too much exercise can cause injuries to the muscle. A long period of rigorous exercise or complete inactivity can also cause muscle irritation. 

The common causes of piriformis-syndrome include:

  • Extensive climbing of stairs
  • Sitting for extended periods at a stretch
  • Exhaustion due to excessive activity
  • Any repetitive activities involving the legs, including running. 

Sometimes, injuries can damage the piriformis muscle to cause pain by pressing down the sciatica nerve. Typical injuries leading to the piriformis-syndrome include: 

  • A direct hit during sports
  • Sudden and bad fall
  • A sudden twist of the hip
  • Serious vehicle accident
  • Penetration wound reaching the muscle 

When to See the Physiotherapist:

It is crucial to see the doctor if you feel numbness or pain in the buttocks continuously for at least a week. The pain will also show up in the legs. Sciatica will linger for several weeks or more, depending on the cause of the condition. Medical consultation is also mandatory when the pain comes and goes frequently.

The doctor's appointment will include a complete review of your medical history, the present symptoms, and then diagnosing the possible causes of the pain. It is important to understand what triggered the symptoms. It would be best if you elaborately discussed the symptoms or a better diagnosis. Don't forget to share the information with your therapist if you had a recent fall or you recall straining a muscle while playing.

Risks Factors for Piriformis Syndrome: 

If you have to sit at a place for long periods, including desk work, you will be at higher risk for piriformis-syndrome. Performing rigorous and regular lower body workouts can also cause the condition. Athletes are prone to the syndrome, especially when having sports injuries.

How to Prevent Piriformis Syndrome:

Although exercises can sometimes cause piriformis-syndrome, regular exercises can also reduce the risk. It would be physically appropriate if you did the following to prevent injuries causing the condition:

  • Avoid running on uneven surfaces and up and down the hills.
  • Warm-up is mandatory before starting a rigorous workout or running. 
  • Gradual increase in the intensity of the sport or exercise that you are doing.
  • Get up frequently and move around to avoid sitting or lying down for a prolonged period. 

Treatments of Piriformis Syndrome: 

The treatment of the syndrome depends upon the chronicity of the syndrome. It will include:

  • Physiotherapy
  • Avoiding exercises that trigger the symptoms
  • Alternate ice and heat application on the legs and buttock. 
  • Various stretches and exercises improve the strength and flexibility of the muscle. 

In serious cases of piriformis-syndrome, you may need injections of the corticosteroids that will provide relief from inflammation to the muscle. 

You may also get some relief after undergoing transcutaneous electrical nerve stimulation or TENS treatment. The TENS device emits electrical energy to stimulate the nerves and suppress the pain signals to the brain.

Related Conditions: 

The piriformis-syndrome can masquerade various common somatic dysfunctions like> 

  • Trochanteric Bursitis
  • Thrombosis of the iliac vein
  • Lumbar osteochondrosis
  • Osteoarthritis
  • Herniated disc
  • Degenerative disc disease
  • Compression fractures
  • Unrecognized pelvic fractures
  • Post-laminectomy syndrome or coccygodynia

Practicing wrong postures and exercising will cause further damage and compression to the nerve. Timely treatment is essential to prevent further deterioration. Follow the doctors' suggestions and do the exercises as per the instructions of the trained experts only.

Frequently Asked Questions

1. How do you soothe piriformis-syndrome?
Electrical stimulation with the help of the transcutaneous electrical nerve stimulation unit or the interferential current stimulator can help stop the pain and alleviate the spasm of the muscle. Progressive stretching of the muscle helps in pain reduction too.
2. What aggravates piriformis-syndrome?
Compression or contraction of piriformis muscle on parts of the sciatic nerve causes the syndrome. So, any type of movement involving the rigorous movement of the lower section of your body, exercise, and sports injuries can aggravate the condition.
3. What is the best exercise for piriformis-syndrome?
Lie on the back with legs straight, lift the affected leg and bend the knee. Gently pull the knee towards your opposite shoulder with the opposite hand. Hold and stretch for 15 to 30 seconds. Repeat the same with the other leg.

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