back pain treatment

Piriformis Syndrome

Piriformis Syndrome

You may have heard of sciatica, a pain that starts in the buttocks and runs down one or both legs. Sciatica is usually caused by pressure or irritation of nerves in the lower back. One condition that causes pressure on those nerves is called piriformis syndrome.

The piriformis is a muscle that extends from the front of the sacrum. That’s the triangle-shaped bone between your two hipbones in your pelvis. The muscle extends across the sciatic nerve to the top of the femur. The femur is the large bone in your upper leg.

The piriformis helps the thigh move side to side. A piriformis muscle spasm can put pressure on the sciatic nerve and cause symptoms. The result is piriformis syndrome.

The sciatic nerve is a thick and long nerve in the body. It passes alongside or goes through the piriformis muscle, goes down the back of the leg, and eventually branches off into smaller nerves that end in the feet. Nerve compression can be caused by spasm of the piriformis muscle.

 

  • Piriformis Syndrome Signs and Symptoms

    • Numbness and tingling in the buttocks that may extend down the back of the leg
    • Tenderness of the muscles in the buttocks
    • Difficulty sitting comfortably
    • Pain while sitting that gets worse the longer you sit
    • Pain in the buttocks and legs that worsens with activity
  • Piriformis Syndrome Diagnosis

    There is no definitive test for piriformis syndrome. In many cases, there is a history of trauma to the area, repetitive, vigorous activity such as long-distance running, or prolonged sitting. Diagnosis of piriformis syndrome is made by the patient’s report of symptoms and by physical exam using a variety of movements to elicit pain to the piriformis muscle. In some cases, a contracted or tender piriformis muscle can be found on physical exam.
    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 Treatment

    If pain is caused by sitting or certain activities, try to avoid positions that trigger pain. Rest, ice, and heat may help relieve symptoms. A doctor or physical therapist can suggest a program of exercises and stretches to help reduce sciatic nerve compression. Osteopathic manipulative treatment has been used to help relieve pain and increase range of motion. Some healthcare providers may recommend anti-inflammatory medications, muscle relaxants, or image guided injections.

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