Chronic Pain

What is piriformis syndrome? The complete story of piriformis syndrome is revealed!

Are you experiencing the unusual pain radiating from spine to buttock? How often do you feel the numbness and tingling sensation running to your feet?

No matter, what kind of pain are you suffering from and what is the intensity of it, pain somehow compromise your functionality.

Piriformis syndrome is the uncommon musculoskeletal syndrome, affecting 10-15% of a population. As compared to men, women are more vulnerable to develop the low back pain due to piriformis syndrome.

In fact, the incidence of piriformis syndrome is six times higher in women than men. Sciatica could not only be the main reason causing the discomfort and pain, yet, it has been estimated that the incidence of piriformis syndrome with sciatica is about 6%.

Interestingly, piriformis syndrome was first described by Yeoman in 1928 as the anterior sacroiliac joint’s prearthritis.

Often neglected, piriformis syndrome is the potential reason of causing low back pain. few reports have been disclosed that many patients who underwent the successful lumbosacral surgery were later diagnosed with the piriformis syndrome.

What is piriformis muscle?

Actually, the piriformis syndrome is related to the piriformis muscle, which is a flat, band-like muscle running from your base of the spine to the thigh bone.

More specifically, it is located in your buttocks. Functionally, this muscle is extremely important for the stabilization of hip joint along with rotating and lifting thigh away from your body.

It seems that these motions are less significant for carrying out our daily activities. Piriformis muscle has a major role in balance maintenance, weight transference from one foot to another, and proper walking.

In short, your every single movement of hip and leg need the assistance of piriformis muscle so that the coordinated and synergetic movement can be executed.

Sciatic nerve passes alongside with the piriformis syndrome. Any pathology of piriformis muscle could lead to the nerve compression. Following are the potential reasons for dysfunction of the piriformis muscle,

  1. Muscle spasm of piriformis
  2. Tightening of the muscle due to injury or spasm
  3. Swelling of muscle due to any injury or spasm
  4. Bleeding in the area of piriformis muscle

Somehow, weak glutes contribute in the development of the piriformis syndrome. Prolonged sitting ultimately deactivates the glutes and hamstrings.

Consequently, whenever you run or walk after prolonged sitting, the muscles won’t work in a coordinated way and the entire strain will be on piriformis muscle, causing the strain. Some experts of sports medicine refer this condition as sleepy glute syndrome.

Pelvic misalignment due to any other issues, including bad posture, and leg length discrepancy can overload the pressure over the piriformis, leading it to work harder. As a result, the muscle will become tighten and go into spasm.

However, if your foot is overpronated, the overworking of piriformis might be possible. So, if you’ve a disturbed gait pattern, get it checked and corrected immediately!

When to get the doctor’s help?

The symptoms of piriformis syndrome mimics to other conditions, including herniated disc, sciatica, and high hamstring tendinitis, so, it’s very tricky to diagnose the piriformis syndrome.

Following are the symptoms determining that rather the piriformis syndrome is the root cause of your butt pain,

  1. Piriformis syndrome doesn’t cause discomfort particularly while running, but you would find sitting, squatting, and climbing stairs painful.
  2. Your buttock may be tender and if excessive pressure is placed on it, you would feel the severe discomfort not only at the certain point, but, down to your leg.
  3. The differentiating factor between the piriformis syndrome and high hamstring tendinitis is you would feel the pain in the middle of glutes if piriformis muscle is hurting, but on the other end, if you’re experiencing the high hamstring tendinitis, then, you would feel the non-radiating pain at the bottom of the butt.
  4. Your pain lasts to few weeks
  5. You would have sudden, severe, and intense pain in your lower back or leg.
  6. You’re feeling numbness or weakness in your leg
  7. After the accident, you would feel the pain
  8. You’re experiencing the problems of controlling bowel or bladder

What is piriformis syndrome

How is the piriformis syndrome diagnosed?

The medical history, a physical examination, and diagnostic tests are the fundamentals of making the diagnosis of piriformis syndrome. somehow, the piriformis syndrome is ruled out after figuring the other possible causes. The X-ray, and MRI can be conducted to exclude other conditions, causing the similar symptoms.

However, the physiotherapist commonly performs FAIR (Flexion, Adduction, and internal rotation) maneuver rather to provoke the sciatic nerve or stretch the irritated piriformis muscle.

How to treat the piriformis syndrome?

Resting is not fairly enough to get piriformis syndrome treated. To relax and loosen the piriformis muscle is the eventual goal while giving the intervention of piriformis syndrome.

By using the foam roller or firm ball, you can massage the tighten piriformis muscle to ease off the pain and discomfort. Stretching could also be helpful in lengthening the muscle.

Try to include piriformis and hamstring stretch in your daily routine. If pain is unbearable, apply hot pack on your buttock or lower back.

Some doctors may recommend the anti-inflammatory medications, corticosteroid injections, and muscle relaxant. Some doctors tried botulinum toxins due to its paralytic properties.

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The evidence showed that botox injections relieve the sciatic nerve compression and muscle tightness to reduce the pain.

TENS and Interferential current also showed positive response in blocking the pain signals and muscle tension in order to treat the piriformis syndrome. in some rare cases, surgery is also recommended.

What are the preventive measures that you should take?

As piriformis syndrome is aggravated with the repeated stresses, such as running or lunging, avoid running or walking on an uneven hill surface.

Before doing any exercise, try to do proper warm up slowly and then gradually increase the intensity. Maintain good posture while sitting, standing or walking. If pain is constant, simply stop the activity and do rest until the pain is subsided.

REFERENCES

http://www.runnersworld.com/tag/piriformis-syndrome

https://familydoctor.org/familydoctor/en/diseases-conditions/piriformis-syndrome.html

http://www.centeredspine.com/piriformis-syndrome-chattanooga/

http://physioworks.com.au/injuries-conditions-1/piriformis-syndrome

http://www.spine-health.com/conditions/sciatica/what-piriformis-syndrome

http://www.spine-health.com/conditions/sciatica/symptoms-and-diagnosis-piriformis-syndrome

http://www.webmd.com/pain-management/guide/piriformis-syndrome-causes-symptoms-treatments#1

https://www.ncbi.nlm.nih.gov/pubmed/22863240

http://emedicine.medscape.com/article/87545-overview#a7

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