Piriformis Syndrome

What Is Piriformis Syndrome?

Pain and discomfort can have many different points of origin: tendons, ligaments, skin, muscles, or nerves. When an injury to the back or spine causes the nerve to be damaged or compressed causing sensations of pain in the buttocks or back of the thigh, the condition is known as sciatica. When it is not the spine that is compressing the nerve, but rather the muscles in the hip, specifically the piriformis muscle, it is called piriformis syndrome. The pain associated with piriformis syndrome is a neuromuscular disorder that involves the piriformis muscle and the sciatic nerve. The piriformis is a muscle that lies deep within your hip and gluteal area. It begins at your sacrum then attaches to the top of your thigh bone and helps with outward rotation of your hip. The sciatic nerve runs from its origin point on the lower spine across the back of the hip and then down the leg.

What Are The Major Symptoms?

Many of the symptoms of piriformis syndrome are very similar to sciatica, including pain, numbness, tingling, and burning sensations that radiate out from the buttocks to the thigh and further down the leg. Sitting for extended periods or engaging in prolonged activities can make this condition worse. It is often aggravated by carrying something thick and bulky in a back pocket, further compressing the gluteal muscles and nerves beneath; this is why the nickname for piriformis syndrome is “fat wallet syndrome.”

What Causes Piriformis Syndrome?

Piriformis syndrome occurs when the gluteal muscle of the same name presses against the sciatic nerve. Usually, the nerve passes beneath the piriformis muscle, but in about 17% of the population it passes right through; this increases the likelihood of piriformis syndrome developing. Other risk factors include:

• inactive gluteal muscles;
• overactive hip flexors;
• too much time spent sitting down;
• overuse of the gluteal muscles, which is frequently seen in cyclists and rowers;
• inadequate stretching before prolonged periods of activity;
• and poor posture and gait while running or walking.

What Are The Treatment Options?

At the beginning of treatment, over-the-counter anti-inflammatory drugs will help relieve the pain and discomfort as well we help loosen tight muscles in the buttocks and hips. Occasionally muscle relaxants are also recommended. Ice on the affected area for 20 minutes every hour for the first 24 – 48 hours can also be helpful. Next, a course of exercise therapy focused on stretching the muscles in the thighs, legs, and buttocks will help relieve the tension and return these muscles to their proper position and alignment. Strengthening exercises for the hip abductors (lift the leg outward), external rotators (rotate the leg outward) and extensors (extend the leg backward) will help long-term and assist in preventing the condition from returning. For those who lived a sedentary lifestyle previously, regular exercise is recommended as well.