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Guide to Piriformis syndrome

What is Piriformis syndrome?

Piriformis syndrome is an uncommon neuromuscular disorder that is caused when the piriformis muscle starts compressing the sciatic nerve. The piriformis muscle is a flat band of muscle located deep in the buttocks and plays an important role in stabilizing the hip joint and rotating the thigh away from the body.

What are the symptoms of Piriformis syndrome?

The symptoms can begin suddenly as a result of a traumatic injury or they can develop gradually in response to repeated irritation.

The symptoms experienced are things such as:

  • Pain, paraesthesia or numbness
  • The pain usually begins around the gluteal region and may radiate down the leg along the course of the sciatic nerve
  • Symptoms are made worse by holding any one position for longer than 20 minutes such as sitting or standing
  • Some may complain of an increase in discomfort when walking, running or climbing stairs.

What causes Piriformis syndrome?

Piriformis syndrome occurs as a result of the muscle being hypertonic (tight) or irritated which leads to compression of the sciatic nerve that runs underneath it. A strain, a fall onto the buttocks or catching yourself from a near fall can irritate the piriformis muscle and lead to hypertonicity. When the sciatic nerve becomes compressed under the muscle as a result of muscle spasms and tightness it leads to neurological ischemia and radicular complaints such as pain and pins and needles.

How is Piriformis syndrome diagnosed?

The diagnosis of piriformis syndrome will be based on an accurate history and physical examination that will be carried out by the practitioner. There will be palpable hypertonicity and tenderness over the piriformis muscle. You may also exhibit an externally rotated hip while at rest.

The clinician may utilise a combination of other clinical tests to rule out any other disorder that may mimic this condition. It is important to remember that most cases of sciatica are not due to piriformis syndrome as it’s very rare.

How is Piriformis syndrome treated?

The main treatment modalities for piriformis syndrome are stretching, myofascial release and the correction of underlying biomechanical dysfunction. Patients should limit any activity that provokes the pain, may it be from sitting too long or climbing stairs.
Conservative treatment will aim to relieve pain and increase the range of motion. This is done through a treatment programme that is designed specifically for you once the practitioner has completed a thorough examination.

References

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