By Dr.Shadman Pandit P.T
What is Piriformis syndrome?
Piriformis syndrome is an uncommon neuromuscular disorder that is caused when the piriformis muscle compresses the sciatic nerve. The piriformis muscle is a flat, band-like muscle located in the buttocks near the top of the hip joint. Piriformis syndrome is predominantly caused by the shortening or tightening of the piriformis muscle. This muscle is important in lower body movement because it stabilizes the hip joint and lifts and rotates the thigh away from the body. This enables us to walk, shift our weight from one foot to another, and maintain balance. It is also used in sports that involve lifting and rotating the thighs – in short, in almost every motion of the hips and legs.
The sciatic nerve is a thick and long nerve in the body. It passes alongside or goes through the piriformis muscle, goes down the back of the leg, and eventually branches off into smaller nerves that end in the feet. Nerve compression can be caused by a spasm of the piriformis muscle.
Symptoms of Piriformis Syndrome:-
Most commonly, patients describe acute tenderness in the buttock and sciatica-like pain down the back of the thigh, calf and foot. Typical piriformis syndrome symptoms may include:
- A dull ache in the buttock
- Pain down the back of the thigh, calf and foot (sciatica)
- Pain while walking up stairs or inclines
- Increased pain after prolonged sitting
- Reduced range of motion of the hip joint
Symptoms of piriformis syndrome often become worse after prolonged sitting, walking or running, and may feel better after lying down on the back.
What causes Piriformis syndrome?
Piriformis syndrome can be developed from everyday activities, such as sitting for long periods of time, climbing stairs, walking, or running, traumatic events, such as a car accident or a fall. This muscle is used when you walk or turn your lower body, shifting your weight from one side to the other. The muscle can become injured or irritated from long periods of inactivity or too much exercise.
Some common causes of piriformis syndrome include:
- overuse from excessive exercise
- running and other repetitive activities involving the legs
- sitting for extended periods
- lifting heavy objects
- extensive stair climbing
See your doctor if you experience pain or numbness in your buttocks or legs that lasts more than a few weeks. Sciatica can linger for several weeks or longer, depending on the cause. You should also see your doctor if your symptoms come and go frequently.
The physical exam will include an examination of the hip and legs to see if movement causes increased low back pain or lower extremity pain (sciatica pain). Typically, the motion of the hip will recreate the pain. The exam will also identify or rule out other possible causes of sciatica pain, such as testing for local tenderness and muscle strength.
Some imaging tests may also be necessary to help rule out other causes of your pain. An MRI scan or a CT scan may help your doctor determine the cause of your pain. If it appears that piriformis syndrome is causing your symptoms, an ultrasound of the muscle may be helpful in diagnosing the condition.
Can Piriformis syndrome be prevented or avoided?
Once your symptoms improve, you may need to change your activities to avoid developing piriformis syndrome again. The following are some tips to help prevent piriformis syndrome:
- Exercise regularly, but always stretch first.
- Maintain good posture when you’re sitting, driving, or standing.
- Don’t lift by bending over. Lift an object by bending your knees and squatting to pick up the object. Keep your back straight and hold the object close to your body. Avoid twisting your body while lifting.
- Avoid sitting or lying down for long periods of time in a position that puts too much pressure on your buttocks.
Piriformis syndrome treatment:-
Most people who have piriformis syndrome get better with treatment and lifestyle changes. Failure to treat this condition can lead to permanent nerve damage, so be sure to follow your doctor’s instructions.
Self-care tips for piriformis syndrome include the following:
- Temporarily stop doing activities that cause pain, such as running or bicycling.
- Take regular breaks to walk around and stretch if you have to sit for a long period of time.
- Use cold packs and warm packs. Start by using a cold pack on the affected area several times a day for about 15 minutes at a time. After using a cold pack for a couple of days, switch to a warm pack or heating pad. If you continue to have pain, alternate between a cold pack and a warm pack.
- Take a nonsteroidal anti-inflammatory drug (also called an NSAID), to help relieve your pain. (Consult your Doctor before taking any medicine)
- Do exercises to stretch the piriformis muscle. Your physiotherapist can give you information about what stretches will help.
- Massage the affected area. If your pain doesn’t get better with self-treatment, your doctor may refer you to a physiotherapist or inject a steroid medicine where the piriformis muscle and the sciatic nerve meet. This may help reduce your pain.If you have severe piriformis syndrome, you may need surgery to relieve the pressure on your sciatic nerve.
‘Consult Physiotherapist for better diagnosis and treatment. Don’t perform any exercise and stretch without consultation.’
Dr Shadman Pandit P.T (MPT(Neuro), MPT(Cardio) Consultant Physiotherapist can be reached at Mob No. 9149965711 Email: [email protected] )