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What is piriformis syndrome? -

Piriformis syndrome occurs when the piriformis muscle compresses the sciatic nerve, leading to a number of symptoms, including pain in the buttocks and/or down the leg.

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What is the piriformis muscle? -

The piriformis is a long, flat muscle that runs transversely in the body, from the lower spine region, through the glutes, and attaches to the top of the thighs.

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What is the piriformis muscle? -

The muscle is found on both sides of the body and plays a key role in the rotation of the hips, impacting nearly every lower body movement.

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What is the sciatic nerve? -

The sciatic nerve is the largest and longest nerve in the body. It runs from the lower back through the hips and buttocks, all the way down each leg.

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How common is piriformis syndrome? -

Piriformis syndrome is fairly uncommon. It is estimated that piriformis syndrome causes about 0.3% to 6% of lower back pain. These numbers are, however, based on diagnosed cases only, and piriformis syndrome is sometimes difficult to diagnose.

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The difference between piriformis syndrome and sciatica -

Both conditions have similar symptoms, as they both are caused by a compression of the sciatic nerve.

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The difference between piriformis syndrome and sciatica -

Sciatica is usually caused by a herniated disc, spinal stenosis, or bone overgrowth, which usually leads to numbness and pain in the lower back, buttocks, and down the leg.

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The difference between piriformis syndrome and sciatica -

Piriformis syndrome, on the other hand, usually only presses on one area of the sciatic nerve, in the buttock. The symptoms are sometimes more localized, but may feel similar to sciatica.

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Causes of piriformis syndrome -

The compression of the sciatic nerve can happen for a number of reasons, including inflammation in the piriformis and/or the tissues surrounding it.

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Causes of piriformis syndrome -

Muscle spasms, as well as scarring of the muscle, may also affect the sciatic nerve and trigger symptoms.

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Causes of piriformis syndrome -

The aforementioned issues can have a number of causes, including a weak piriformis muscle that can get inflamed by activities such as walking, running, or climbing stairs.

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Causes of piriformis syndrome -

Inflammation, muscle spasm, or scarring can also be a result of an accident or damage incurred by improper weight lifting.

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Causes of piriformis syndrome -

A lack of warm-up, or performing activities that require more mobility and flexibility than that person has, might also cause damage to the piriformis muscle.

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Causes of piriformis syndrome -

Too much and too little activity may also be culprits. For example, overexercising and repetitive motions can be detrimental, but so can sitting for long periods of time.

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Primary piriformis syndrome -

While most causes of piriformis syndrome are acquired, there are rare instances when abnormal anatomy is the root of the problem. This can be things such as an unusually formed piriformis or an abnormal sciatic nerve path. This is known as primary piriformis syndrome.

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Symptoms of piriformis syndrome -

We’ve mentioned the numbness and pain, but there are other symptoms associated with piriformis syndrome, including a tingling or burning sensation.

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What can make it worse? -

These symptoms tend to aggravate when we engage in certain activities, which may include running, sitting for long periods of time, or climbing stairs.

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Diagnosis -

As previously mentioned, the diagnosis of piriformis syndrome can be difficult, but your healthcare provider may be able to assess your symptoms and get cues from your medical history, injuries, and activity habits.

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Diagnosis: physical tests -

Your healthcare provider may also perform a number of physical tests, such as moving your hip and leg, to assess what hurts, when, and how much it hurts.

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Diagnosis: other tests -

Depending on your specific case, a number of tests may also be prescribed; mostly to rule out other conditions (i.e. herniated disc). These may include an ultrasound, CT scan, MRI, and an electromyogram (EMG).

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Treatment -

Treatment is usually tailored to what is triggering the piriformis syndrome, inflammation being the easiest to treat. Initially, rest from activities that may aggravate the symptoms is recommended.

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Treatment -

Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually prescribed to reduce swelling and therefore put less pressure on the sciatic nerve.

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Treatment -

Those looking to alleviate the symptoms of piriformis syndrome and help treat it may also use massage and perform specific exercises to strengthen and stretch the muscle. These should be prescribed by a physical therapist.

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Treatment -

Other treatments include taking muscle relaxants, or being administered steroid or Botox injections.

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How to prevent piriformis syndrome? -

There are a few things that can be done to prevent recurring piriformis syndrome episodes, including regular exercise and focusing on good posture.

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Outlook -

With adequate treatment, symptoms of piriformis syndrome are often resolved in a few days or weeks. Lifestyle changes may help prevent it from happening again (or at least not frequently happening).

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When to seek immediate medical assistance -

While piriformis syndrome is not usually life-threatening, if you experience symptoms such as difficulty in controlling your bowels or bladder, you should seek immediate medical assistance.

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When to seek immediate medical assistance -

Sudden numbness or weakness in your back or leg is also a warning sign, as is not being able to lift your foot up from the floor.

Sources: (Cleveland Clinic) (Spine-health) (HealthCentral)

See also: Helpful ways to deal with chronic pain 

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