The piriformis is an inaccessible muscle that connects the spine to the thigh bone. This pyramid-shaped muscle is situated deep in the buttocks, close to the hip joint that joins the sacrum to the head of the femur.
Balance, joint stability, and lower-body movement are crucial aspects of the piriformis muscle. This little muscle's primary function is to stabilize the sacrum and assists the hip joint flexion, rotation, and movement.
It is involved in practically every function of the hip and aids in walking, lifting, and many other tasks of daily living. This muscle is situated so near to the sciatic nerve that, when it contracts, it exerts pressure on the nerve. When it begins to press against the sciatic nerve, typically due to extended sitting, it can create a sharp pain. It is termed piriformis syndrome when the piriformis is tight or irritated.
The sciatic nerve, the longest and biggest nerve in your body, often causes pain felt on one side of the low back and buttocks. Due to the nerve's lengthy route from the lower back to the legs and feet, however, several structures might contribute to sciatic nerve discomfort.
According to experts dealing with pain management upper marlboro md, sciatica often arises when a herniated disc presses on the sciatic nerve, although the nerve can also become entrapped by the piriformis muscle.
Piriformis Syndrome vs. Sciatica
First, it is essential to understand that sciatica and piriformis syndrome share similar symptoms. This is why it is so simple to confuse them with one another. The common symptoms of piriformis syndrome are:
- When seated, buttocks pain is exacerbated.
- Pain in the contralateral sacroiliac joint.
- Discomfort while sitting or standing for 20 minutes
- Pain while seated or squatting.
- Pain is felt from the sacrum down the back of the leg, which often terminates slightly above the knee.
- Pain that diminishes with motion
- Neuralgia of the foot
The most crucial point is that various illnesses have distinct underlying causes. Sciatica is a collection of symptoms produced by an underlying condition, such as a herniated disc. Piriformis syndrome develops when the piriformis muscle in the deep pelvis irritates or compresses the sciatic nerve.
Piriformis syndrome and sciatica are distinct conditions.
Piriformis syndrome and sciatica are two distinct medical disorders. However, they are sometimes confused because piriformis syndrome can create symptoms similar to sciatica.
Both piriformis syndrome and sciatica impact the functioning of the sciatic nerve, which is the body's biggest nerve. It extends from the low back to the hips, buttocks, and legs.
Sciatic neuritis can occur when your spine presses on a nerve root in your lower back, usually due to a herniated disc (sciatica). Piriformis syndrome can occur if the piriformis muscle adds pressure on the sciatic nerve.
Since the fundamental causes of the two disorders differ, it is essential to have a professional diagnosis.
Piriformis syndrome symptoms may mirror sciatica.
Because piriformis syndrome indicates a pinched sciatic nerve, the symptoms may match sciatica. Despite the individual variation, the most frequent piriformis syndrome symptoms include:
- Buttock pain that is either sharp or dull
- Pain similar to sciatica radiating down the leg
- An ache that worsens when climbing hills or stairs
- Pain that worsens during prolonged sitting
- Restricted hip range of motion
Generally, the symptoms of piriformis syndrome worsen with physical activity or extended sitting and ease when lying on the back.
It is uncertain what causes piriformis syndrome.
Researchers continue to investigate why specific individuals get piriformis syndrome. They know that it occurs when the piriformis muscle compresses the sciatic nerve, but they do not know the particular cause.
When the piriformis muscle is injured, it can spasm, enlarge, and become exceedingly tight. These disorders can cause piriformis syndrome by putting pressure on the sciatic nerve beneath the muscle.
The following conditions or circumstances are most strongly associated with the development of piriformis syndrome:
- Sitting for extended durations.
- Trauma or injury to the piriformis muscle (e.g., surgery, car accident, bad fall)
- During running and other repeated leg movements
- Having to ascend several steps
- Performing heavy lifting
Researchers suggest that overuse of the piriformis muscle due to excessive exercise may contribute to the illness. If more than one of the criteria listed above applies to you, your risk increases.
No conclusive test exists for piriformis syndrome.
No one test can definitively diagnose piriformis syndrome. Visiting a specialist in nerve pain is essential for therapy. Pain management specialists have extensive expertise in identifying and treating nerve disorders. They can determine whether your spine or piriformis muscle causes your problems.
A doctor evaluates your back, hip, pelvis, sacroiliac joint, walking style (gait), leg length, and posture. He may utilize further tests to assess your reflexes and rule out other problems.
Piriformis condition can be cured.
There are effective therapies for piriformis syndrome if a proper diagnosis has been made. Procedures always begin therapy with minor invasive treatments and advances as necessary to more intensive therapies.
The treatments for piriformis syndrome are determined by the patient's symptoms, present health, and medical history. Your individualized treatment approach for piriformis may involve one or more of the following:
- Heat and ice treatment
- Physical treatment
- Medications are sold over-the-counter or by prescription.
- Transcutaneous electrical nerve stimulation
- Therapeutic rubdown
- Botulinum toxin injections
- Injections of corticosteroid hormones
- Surgical decompression of the nerve
If your problems continue despite additional therapies, your doctor will recommend surgery. Incisions are made in the piriformis muscle to relieve it and the tendon causing nerve compression.
Treatment of Piriformis Syndrome
As you might have guessed from the vagueness of the symptoms and diagnostic criteria, piriformis syndrome is not a well-studied ailment in athletes or the general public.
Even studies of piriformis syndrome in athletes are challenging, so the therapy approach will depend more on theory than on high-quality clinical trials.
Most advised therapies for piriformis syndrome in the scientific literature target the painful or inflamed piriformis muscle, which supposedly is the source of buttock and leg pain.
This comprises mainly of stretching and strength training activities. If the piriformis operates as an internal rotator and abductor while the hip is in flexion, we may stretch it by externally rotating and abducting the hip.
Additional Piriformis Syndrome Treatment Alternatives
Although there is little information in the scientific literature regarding treating piriformis syndrome in runners, the condition is prevalent enough for several “folk remedies” and workarounds to have developed. Included among these are:
- Avoiding activities that aggravate the piriformis muscle is another standard treatment for piriformis syndrome. Prolonged sitting, in particular, may be particularly aggravating, so altering your routine, so you don't need to sit as frequently or for as long might be beneficial.
- By massaging or stretching the piriformis muscle, stiffness can be reduced. Athletes do this by rolling their glutes on a tennis ball or lacrosse ball perfectly shaped to apply enough pressure on the glute area.
- Standing workstations are gaining more popularity, and taking a little break every hour helps you stretch your piriformis. Experimenting with different sitting surfaces that are more complex, softer, flatter, or more contoured may minimize discomfort if nothing else.
- If you can still run, avoiding exercises or situations that aggravate your piriformis will also be beneficial; frequent irritants include fast speeds, uphill and downhill jogging, and tight bends.
- Deep tissue massage techniques such as Active Release Technique (ART) and Graston Technique are also popular. They may achieve the same objective as the “myofascial release” massage techniques outlined in several physical therapist case studies.
Therapy for people who have tried all other options.
These therapies are more expensive, and their effects are less predictable, but they may be effective if you are fed up with your discomfort. Collaborate with a physical therapist to design a personalized rehabilitation program.
Due to the lack of research on optimal exercises for treating piriformis syndrome in runners, it may be prudent to consult a physical therapist if your condition is very severe or persistent. Thus, you will be able to treat any physical stiffness or weakness that may have contributed to your injury.
Taking precautions against piriformis syndrome is your best hope for preventing severe discomfort. Because the condition can be induced by sedentary behavior or excessive activity, it is crucial to avoid both extremes. Adding physical stretching to your everyday routine can help you avoid piriformis syndrome.
If you are experiencing lower back or buttock pain, an orthopedic doctor or surgeon can do a physical test to determine the source of your discomfort and devise a treatment plan.