What is Piriformis Syndrome?
Piriformis syndrome is a neuromuscular condition that happens when the piriformis muscle compresses the sciatic nerve, causing pain and discomfort in the buttocks and hips that sometimes extends down into the lower leg.
The sciatic nerve connects the spinal cord in the low back to the nerves and muscles in each leg. In most people it runs under the piriformis muscle, which is located deep in the buttock area.
Piriformis syndrome can cause symptoms resembling sciatica, however, the two are different conditions; sciatica occurs due to lower spine problems such as a herniated disc, lumbar spinal stenosis or lumbar degenerative disc disease.
What Causes Piriformis Syndrome?
There is no one cause of piriformis syndrome, but factors that increase your likelihood of developing it include:
- Gender – piriformis syndrome is six times more common in women, most likely because of anatomical differences
- Sitting for too long over time, especially on hard surfaces, which can directly compress the sciatic nerve and is sometimes called wallet sciatica or wallet neuritis
- Direct trauma or blow to the buttocks which causes inflammation and enlargement of the piriformis muscle which can irritate the sciatic nerve
- Muscle spasms which can irritate the sciatic nerve
- Previous injuries or surgeries to the area, such as a hip replacement
- Long-term, repetitive strain or overuse, whether occupational, such as truck driving, or recreational, such as rowing, long-distance walking, running or cycling
- Anatomical variation – sometimes the sciatic nerve runs through the piriformis muscle rather than under it
- Dysfunction of the piriformis muscle due to altered biomechanics of the low back, legs, or pelvis
What are the Signs and Symptoms of Piriformis Syndrome?
The most common symptom of piriformis syndrome is pain in the buttock or hip area, which can come and go, or become chronic.
Other signs and symptoms of piriformis syndrome include:
- Numbness and tingling and/or radiating pain from the buttock down into the leg
- Pain that is worse with sitting or standing for too long, squatting, or climbing stairs
- Low back pain
- Pain with bowel movements
- Painful intercourse (this mostly occurs in women)
- Tenderness in the buttock when pressed
How is Piriformis Syndrome Treated?
Piriformis syndrome is often misdiagnosed, as symptoms can be similar to sciatica. However, if it is diagnosed early, you will be less likely to develop chronic pain.
Treatments for piriformis syndrome include:
- Medications, including:
- Non-steroidal anti-inflammatory drugs (NSAIDs), either prescribed, or over-the-counter, such as Advil, Motrin or Aleve
- Topical medications such as creams, sprays, gels or patches
- Muscle relaxants
- Injections of anesthetics, corticosteroids, or botulinum toxin
- Surgery – if surgery is necessary after other less invasive treatments have not helped, physiotherapy is an important part of rehabilitation
Physiotherapy for Piriformis Syndrome
Physiotherapy is a drug-free and non-surgical treatment that focuses on reducing pain, preventing chronic pain, regaining strength, and increasing mobility and function.
Depending on your individual needs, physiotherapy for piriformis syndrome can include:
- Stretching, strengthening, and range of motion exercises
- Activity modification and functional retraining
- A personalized exercise routine
- Patient education including postural and ergonomic education
- Cross-disciplinary pain-relieving therapies such as:
Are you seeking physiotherapy for piriformis syndrome? Book an assessment today.
Can Piriformis Syndrome Go Away on Its Own?
With proper treatment, piriformis syndrome can get better, however, without activity modification, symptoms are likely to recur.
If you have piriformis syndrome, there are things you can do to make day-to-day living easier, including:
- Minimizing or avoiding activities that exacerbate the pain
- Avoiding sitting for too long (over 30 minutes), especially on hard surfaces – do not sit on your wallet
- Switching from high-intensity activities like jogging, to low-intensity activities like swimming once the pain is gone
- Applying heat and cold therapy
- Using an ergonomic chair at work and home
Can You Prevent Piriformis Syndrome?
There are steps you can take to prevent or reduce the chance of developing piriformis syndrome, including:
- Exercising regularly, including stretching exercises such as yoga or tai chi, at least 30 minutes every day
- Staying active; avoid staying in one position for too long
- Warming up before exercise and stretching afterward
- Eating a non-inflammatory diet (avoiding sugar, and processed and refined foods) and drinking plenty of water
- Maintaining a healthy weight
- Using an ergonomic chair at work and home
Book a Physiotherapist Consult for Piriformis Syndrome Today
Concerned about symptoms of piriformis syndrome? Book an assessment with a physiotherapist today.