Piriformis Syndrome

//Piriformis Syndrome
Piriformis Syndrome 2018-08-28T18:37:46+00:00

What Is Piriformis Syndrome?

If you’re suffering from a deep sort of pain that runs from your buttocks and down through your legs, you could have piriformis syndrome. This condition can often lead to sciatica, another form of leg pain. Here’s what you should know about causes and treatments that can help.

Piriformis syndrome is a neuromuscular condition that’s often caused by injury or irritation of your piriformis muscle. The piriformis muscle is found deep within your gluteal region. The top of this muscle is attached to the base of your spine within the lower back. The bottom of the muscle attaches to the top of your femur on the lower limbs. The piriformis muscle lays flat and somewhat parallel with your gluteus medius muscle.

This muscle does a lot for your body, especially when it comes to movement. The piriformis muscle helps rotate your femur from the hip. While you’re walking, this same muscle assists with balance and stabilization by helping to flex your thigh muscles and shift weight back and forth between your limbs. Because of all it does, it can be more prone to injury, strain, overuse, or trauma.

Irritation and damage to the piriformis muscle can cause inflammation, which in turn places pressure on the surrounding tissues and structures. One of the major nearby nerves is the sciatic nerve. When you’re suffering from pain related to piriformis syndrome, you’re really experiencing pain from the compression of your sciatic nerve.

Piriformis Syndrome: Symptoms, Causes, & Treatments | PainDoctor.com

Anatomy of piriformis muscle and sciatic nerve

What does piriformis syndrome feel like? 

If you have piriformis syndrome, you’ll often experience lower back pain. Recent prevalence rates have estimated that between 40% and 50% of all adults will experience some form of lower back pain at some point in their lives. Estimates suggest that 5%-36% of these cases of lower back pain could be related to piriformis syndrome. However, these numbers may be even lower than actual rates since many cases go undiagnosed.

Piriformis syndrome symptoms can widely vary. If you’re suffering from this condition, some of the more common piriformis syndrome symptoms include:

  • Pain that worsens following prolonged periods of sitting
  • Pain that you feel around the area of the piriformis muscle and the sciatic nerve, especially where the muscle attaches to the base of the spine and the top of the femur
  • Numbing sensations within the feet
  • Pain walking up stairs or an incline
  • Headache
  • Muscle weakness in the lower limbs
  • Difficulty walking
  • Reduced range of motion within the hip joint
  • Radiating pain
  • Abdominal pain, pelvic pain, or groin pain
  • Muscle spasms
  • Pain during bowel movements
  • In women, pain during intercourse

Your pain may range from a dull and generalized ache within the area to a more acute and sharp stabbing pain. Also, many people experience their symptoms differently. How you experience piriformis syndrome pain will typically depend on the specific underlying injury or strain.

Piriformis Syndrome Causes

The exact cause of piriformis syndrome is not well understood.

Previous studies have indicated that only about half of patients with piriformis syndrome had injury or trauma to the area in the past. Overburden of the piriformis muscle can be a cause of inflammation within the tissue, which thereby increases the pressure placed on surrounding tissue, including the sciatic nerve.

Several chemicals may also play a role in the development of inflammation and irritation in the area. These include:

  • Histamine
  • Serotonin
  • Prostaglandin
  • Bradykinin

Further, some evidence has suggested that individuals who regularly participate in activities involving jumping, running, or lunging are more at risk for developing complications associated with piriformis syndrome. This condition is also more common in women than men.

Diagnosing piriformis syndrome

Your doctor can determine whether your symptoms of pain are associated with piriformis syndrome. They’ll generally start with a physical examination and an in-depth set of questions about your pain. Specifically, your doctor will want to know:

  • The course of your pain
  • A description of your current symptoms
  • If you’ve had any recent injuries
  • Which treatments have helped manage pain, and which had no effect
  • Any other relevant information

Piriformis Syndrome Treatments

If you’re suffering from piriformis syndrome, there are treatments that can help. A number of effective treatment options help manage the discomfort and pain that accompany irritation or injury of the piriformis muscle and sciatic nerve.

For more mild cases of piriformis-related pain, at-home treatments can be highly effective in reducing your pain and discomfort. These may include:

  • Ice therapy
  • Ice massage
  • Heat therapy
  • Foam rolling
  • Rest

Biofeedback and physical therapy are two other therapies that can help many patients.

Treatments for moderate to severe cases

Medications are also available to treat the pain and discomfort of piriformis syndrome. In particular, non-steroidal anti-inflammatory medications (NSAIDs), such as naproxen or ibuprofen, may help. These can help relieve pain and inflammation. Other oral analgesics that may be beneficial for treating piriformis syndrome pain include acetaminophen, antidepressants, and gabapentin.

Though it is relatively uncommon, some cases of piriformis syndrome do not respond to more conservative methods of treatment. Thus, your doctor may try more significant interventions. These procedures may include non-surgical nerve blocks or spinal cord stimulation. Both of these treatments work by blocking the transmission of pain information to the spinal cord and brain.

Conclusion

Piriformis syndrome is a neuromuscular condition characterized by pain owing to compression of the sciatic nerve by inflammation within the piriformis muscle. This muscle, located deep within the buttocks, can become inflamed as the result of strain, overuse, or trauma.

A wide range of treatment options are available to manage the discomfort associated with the condition. These can range from at-home treatments, such as heat or ice therapy, to more significant interventions, such as the nerve block. Individuals are encouraged to speak with their doctor about the risks and benefits associated with each treatment option available.

If you’re suffering from a moderate to severe case of piriformis syndrome that hasn’t responded to other treatments, you may need to talk to a pain specialist. You can find a pain doctor in your area by clicking the button below or looking for one in your area by using the tips here: https://paindoctor.com/pain-management-doctors/.

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References

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  2. Halpin RJ, Ganju A. Piriformis syndrome: A real pain in the buttock? 2009;65(4 Suppl):A197-202.
  3. Hopayian K, Song F, Siera R, Sambandan S. The clinical features of the piriformis syndrome: A systematic review. Eur Spine J. 2010;19(12):2095-109.
  4. Kirschner JS, Foye PM, Cole JL. Piriformis syndrome, diagnosis and treatment. Muscle Nerve. 2009;40(1):10-8.
  5. Miller TA, White KP, Ross DC. The diagnosis and management of piriformis syndrome: Myths and facts. Can J Neurol Sci. 2012;39(5):577-83.
  6. Tagliafico A, Bodner G, Rosenberg I, Palmieri F, Garello I, Altafini L, Martinoli C. Peripheral nerves: Ultrasound-guided interventional procedures. Semin Musculoskelet Radiol. 2010;14(5):559-66.

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