What is Piriformis Syndrome?

Do you have sciatic nerve pain? Did you know piriformis syndrome can cause sciatic nerve pain?

The piriformis muscle is found in the buttocks around the top of your hip joint.  This band-like, flat muscle rotates the thigh and stabilizing the hip joint.  Without this muscle, we would be unable to maintain balance, shift our weight from leg to leg, or even walk. The piriformis is necessary for any movement involving rotating or lifting the thighs. This can include many sports and exercise. Any motion that uses the hips or legs relies on the piriformis muscle.

Sometimes, spasms of this muscle can lead to compression of the sciatic nerve.  The sciatic nerve goes through the piriformis muscle and runs alongside it.  The sciatic nerve travels down the back of your leg. It then splits into smaller nerves in your feet. When the piriformis muscle spasms, it can cause a lot of problems with your sciatic nerve.

Is your Pain Piriformis Syndrome?

It may be hard to differentiate between sciatic pain and piriformis syndrome. The two conditions share many symptoms. Piriformis syndrome generally involves pain, numbness or tingling of the buttocks. The pain can be quite severe and may run the entire length of the sciatic nerve, causing sciatica.  Sometimes the piriformis muscle compresses the sciatic nerve, causing pain and discomfort. Sitting, climbing stairs, and putting pressure on the piriformis muscle worsens symptoms.

No test specifically pinpoints piriformis syndrome. But there are key indicators that you might have piriformis syndrome. Your doctor will look for a history of pain and vigorous or repetitive motions. Some repetitive motions include prolonged sitting or long-distance running. During a physical exam, the doctor will use a specific series of movements as tests. If a patient reacts to movements with pain, the doctor diagnoses piriformis syndrome. At times, the muscle itself will appear tender and contracted during the exam.

The symptoms of piriformis syndrome can mimic other conditions. These conditions include disc herniation. So your chiropractor may order an MRI.

Your Chiropractic Examination

Your chiropractor will check your pelvis, spine, and muscles when assessing your risk of piriformis syndrome.  Your doctor will order a complete neurological and orthopedic exam. Since piriformis syndrome mimic s other conditions, your chiropractor may order an MRI.

Some of the signs your chiropractor is looking for may include:

• Pain that worsens on climbing stairs, sitting, walking, running or doing squats. These symptoms aren’t definitive for diagnosing piriformis syndrome by themselves. Your doctor uses these symptoms to rule out other causes for your pain.

• Testing for tendinitis with resisted muscle testing.  Again, this isn’t a standalone diagnostic tool. The piriformis works with other muscles in the buttocks. Doctors also test the Superior and Inferior gemellus and the Obturator internus and the quadratus femoris. Each test helps form a diagnosis.

• One foot that rotates outward more than the other foot when lying on your back, relaxed.

• Pain that increases by passively or externally rotating the hip.

• Tender and tight muscles that may involve painful trigger points when directly palpated. The pain can radiate down your legs.

• Weakness in the muscles surrounding the area, with dysfunction of the joints in your sacroiliac.

• Testing to rule out injuries of the spine, such as disc herniation. Bonnet’s test is one diagnostic tool to check for irritation of the sciatic nerve. This could mean you have a tight piriformis muscle.

Your Chiropractor and Piriformis Syndrome Treatment

Treating piriformis syndrome can be difficult. Some treatments only masked the symptoms, rather than treating the underlying cause. Many doctors use muscle relaxers, over-the-counter medications, and anti-inflammatory drugs. While these drugs reduce pain and inflammation, they do not treat the cause of pain. Muscle injections are often needed for severe pain. Other treatment plans can include massage, heat therapy, and exercise.

Your chiropractor treats the body as a whole. That means your treatment will extend to other parts of the body that may seem unrelated at first. Treating other areas of the body allows the piriformis muscle to loosen. Chiropractors may focus on spine, pelvis, or limb. This allows for a natural and complete healing process.

If you address the problem causing piriformis syndrome, you can return to normal activities. The ultimate goal is to keep the condition from recurring. Your chiropractor may suggest different activities and exercise routines for the future.

Schedule an evaluation with your chiropractor if you think you have piriformis syndrome. Don’t let back pain go untreated. 

Some risk factors for developing chronic back pain are:

• Poor posture
• Poor core muscle strength, limited spinal stability, and poor levels of fitness
• Prior back pain episodes
• Pain that lasts more than eight days

In other words, the longer you have untreated back pain, the more likely you will suffer chronic or recurring back pain. To live pain free, it is important to have a prompt diagnosis and a treatment plan.