When the sciatic nerve, the longest and widest nerve in the body, is compressed by the piriformis muscle, this condition is referred to as piriformis syndrome. The piriformis muscle is located deep in the hip and connects to the pelvic bone and the femur. The sciatic nerve contacts the piriformis muscle as the nerve traverses the sciatic notch of the ilium bone. This muscle can become inflamed or spasmodic due to a variety of reasons, and when it swells it can trap the sciatic nerve against the wall of the sciatic notch. This irritates the sciatic nerve, giving painful sciatic symptoms of tingling, numbness and weakness that may travel to as far as the feet and toes.
Causes of piriformis syndrome
Piriformis syndrome can be caused by two types of muscle injury:
- Overload – as the name implies, this type of strain can be the result of rough sports, lifting heavy objects without proper back support, overstretching or any other type of overexertion. The discomfort of overload pain is usually acute (lasting less than three months) and will abate with conservative treatments like hot-cold therapy and pain medication.
- Biomechanical inefficiencies – this type of muscular injury involves persistent and prolonged misuse of the piriformis muscle, such as bad posture while sitting at a desk or improper jogging technique. It can also involve structural factors, like flat feet or misaligned leg length.
Treatment options for piriformis syndrome
The majority of patients who experience sciatic symptoms due to piriformis syndrome are able to find meaningful pain relief with conservative treatment. It’s important to work with a physician to develop an individualized treatment plan, but common methods include physical therapy, deep tissue massage, non-steroidal anti-inflammatory drugs, hot therapy and cold therapy.