Piriformis Syndrome: Signs, Symptoms, Treatment, and Management

Photo credit: Bigstockphoto
Photo credit: Bigstockphoto

Piriformis syndrome is a type of neuromuscular disorder that affects the sciatic nerve. The sciatic nerve is a large nerve that runs from the lower back to the buttocks and down the lower legs. When the sciatic nerve is inflamed or compressed, pain, numbing and tingling occurs in the buttocks. The pain gradually spreads to the lower limbs.

The pain affects the piriformis muscle. The piriformis muscle is a flat band of muscle in the buttocks, just on the top of the hip joint. This muscle helps balance the hip joint and rotate the thighs. This muscle allows us to walk and shift weight from one foot to another. If the piriformis muscle is compromised in any way, mobility is greatly affected. Sustained injury from an inflamed sciatic nerve leads to piriformis syndrome.

Piriformis Syndrome Signs and Symptoms

Piriformis syndrome starts with unexplained pain or numbness in the buttocks area. The pain can be severe enough to affect day-to-day activities. The pain will start moving to the length of the lower body because of the pinched sciatic nerve. Walking, running or climbing the stairs will become a painful affair. The pain is also triggered each time you walk or run.

During a physical checkup, the doctor will run through several tests to diagnose this condition. You will be asked to perform physical movements to elicit pain on the affected area. Unfortunately, piriformis syndrome shares similar symptoms with other conditions. This makes it hard to diagnose the condition. Also, the lack of standardized diagnostic tests makes it hard to detect this condition. The best way to diagnose piriformis syndrome is through radiologic tests such as MRIs to detect a compressed sciatic nerve.

Treating and Managing Piriformis Syndrome

Piriformis Syndrome is caused by pressure on the sciatic nerve. Therefore, any movement or activities that cause strain on the sciatic nerve has to be minimized or eliminated altogether. Usually, sitting for too long or standing up for too long can cause pinched sciatic nerve. It helps to perform non-strenuous exercises like yoga or Pilates to ease pressure on the sciatic nerve. Of course, your doctor will develop an exercise program to help minimize sciatic nerve compression.

Your doctor may also recommend going through osteopathic manipulative treatment. This treatment will help alleviate pain and boost the range of motion. Taking a muscle relaxant, anti-inflammatory medications and corticosteroid injections may relieve pain temporarily.

For severe cases of piriformis syndrome, you may opt for iontophoresis, in which a mild electric current is applied on the affected area. Some doctors are also prescribing a shot of botulinum toxin or Botox to relax the piriformis muscle and minimize pain. If the pain is so severe and no other treatment works, your doctor may recommend surgery as a last resort.

How to prevent Piriformis Syndrome

Save yourself a lot of pain by not abusing your body. Avoid activities that cause strain on the sciatic nerve or the piriformis muscle. Running, lunging, sitting for too long or running in uneven grounds could all cause sciatic compression. If you must run, observe the proper form so the weight is evenly distributed to the rest of the body. Finally, if pain occurs as you work out, rest. Stop all physical activities until the pain goes away completely. If pain persists, consult a health care provider.


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