Piriformis Syndrome refers to deep-seated pain in the
hip and buttocks that cannot be attributed to any other
condition. Some doctors say that, as a specific condition,
it doesn't exist but the many sufferers of this painful
and debilitating condition are not convinced.
The name 'piriformis syndrome' is taken from the muscle
in the hip region which called the piriformis muscle.
This is a relatively small muscle that lies behind the
hip and helps in the action of turning the leg out;
this action is referred to as external rotation.
The
tendon of the piriformis muscle, where it attaches to
the sacral spine, crosses the path of the sciatic nerve.
It is believed that the piriformis tendon can create
pressure on, aggravate or inflame the sciatic nerve
at this point, causing pain in the buttocks or hip.
The theory is that this irritation occurs when the piriformis
muscle is tight, as happens with many people who have
sedentary occupations.
Another cause of the piriformis syndrome is spasm of
the muscle which can be the result of injury while exercising.
The condition is particularly associated with activities
that involve running and changes of direction, especially
when running on hard or uneven ground. People who return
to heavy exercise or increase the intensity of their
activity too soon are also liable to suffer this condition.
The pain associated with piriformis syndrome is usually
described as a deep ache in the hip or buttocks, often
only on one side. However, this type of pain, in this
area, could also be caused by sciatica, herniated disc,
tendonitis or spinal stenosis. When these causes have
been eliminated, a diagnosis of piriformis syndrome
is often made.
To further confirm the diagnosis, the
upper leg may be manipulated to isolate the piriformis
muscle's function and to discover if the pain is in
the region of the piriformis tendon. Other symptoms
include pain in the lower back or leg, stiffness and
difficulty of movement. Some patients experience numbness
or tingling in the feet and legs.
Having made a firm diagnosis of piriformis syndrome,
the doctor has several treatment options. If the symptoms
have been caused by specific activities, resting or
avoiding these activities for a few weeks will usually
allow the pain to subside. Anti-inflammatory medication
can also be prescribed to relieve the irritation of
the sciatic nerve caused by the piriformis tendon.
Massage
therapy is another treatment option as deep massage
by a trained therapist can relieve the pressure on the
sciatic nerve. Possibly the most effective long-term
treatment is physical therapy, supervised and assessed
by a physiotherapist or exercise physiologist. The physical
therapy will focus on stretching the muscles of the
hip and thigh, particularly the piriformis, and strengthening
the muscles that rotate the hip.
The options for treatment of piriformis syndrome are
fairly general in nature and treatment may not always
be effective in the long-term. This is a condition that
can be difficult to get a full recovery. Surgery to
loosen the piriformis tendon is considered a last resort
treatment and is only considered if the symptoms are
severe and haven't responded to lengthy treatment by
other methods.
The best way to prevent piriformis syndrome is to make
certain you warm up properly before any exercise or
strenuous activity and to stand up, stretch and walk
around regularly if you need to be sitting for extended
periods of time.
Video: Sciatica and Piriformis Syndrome: Dr. Aaron Filler
