Piriformis syndrome

Piriformis syndrome is a painful condition of the low back or buttocks, caused due inflammation in the piriformis muscle or due to the piriformis muscle impinging upon the sciatic nerve. Other symptoms include numbness and tingling along the back of the thigh.

Piriformis muscle plays an important role in lower body movement helping us walk, shift our balance from one leg to another and lifting and rotating our legs.

Signs and symptoms:

1. It usually starts with pain, tingling and numbness in the buttocks. pain can be severe and extend along the length of the sciatic nerve.
2. Reduced rang of motion of hip joint.
3. Pain when walking up stairs.
4. Increase pain after prolonged sitting.

Sciatic nerve passes through the piriformis muscle, along the back of the leg, branching off into smaller nerves at the feet. There are of course several anatomical variations of the course of sciatic nerve. However, sciatica is not always due to piriformis syndrome.

Some of the causes include:

Injury or irritation to the piriformis muscle can cause mucle spasms. Muscle spasms may inturn be caused due to:

• Over exercising
• Prolonged siting
• Lifting heavy objects
• Trauma such as accidents, falls, sudden twisting of the hip can also cause muscle irritation and damage.

Women are at a higher risk of experiencing piriformis syndrome because of the higher Q angle.

Diagnosis:

• Diagnosis is usually through exclusion, which means your doctor will diagnose you piriformis syndrome after eliminating other potential causes.
• Your doctor will perform physical examination, moving the affected leg in several different positions.

It is called ‘syndrome’, because it is actually explaining the region of the pain, not the defect causing the pain, since it includes multiple tissues and muscles.

• An MRI is used to rule out other conditions if your situation is unclear.

Treatment:

1. Conservative measures such as rest from activities triggering the symptoms.
2. Over the counter pain killers may be prescibed to reduce pain and swelling.
3. Steroid injection into the muscle may relieve the pain.
4. Exercises for strengthening the hip muscles and stretching pyriformis muscle.
5. Botox injection into the muscle may help.
6. As a last resort,surgery to decompress sciatic nerve may be recommended.

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