What is Piriformis Syndrome and How to Treat it?
Piriformis is a tiny slim muscle that runs from your spine to the thigh bone (behind the Gluteus Maximus). The Piriformis muscle enables the rotation of hip and the turning of the leg and foot outward from the body. This allows us to walk, shift weight from one foot to another, and maintain balance.
Piriformis plays an important role in rotation of hips and legs. These motions are actively performed in sports that involve lifts and rotation of the thighs.
Piriformis syndrome is an uncommon neuromuscular disorder, caused as a result of the compression of the sciatic nerve by the Piriformis muscle. Muscle spasm, tightening of the muscle, swelling and bleeding in the area of the Piriformis muscle are also believed to cause the Piriformis syndrome.
The sciatic nerve is a thick and long nerve which passes alongside or goes through the Piriformis muscle, passes down the back of the leg and eventually splits into smaller nerves that reach the foot.
Sciatica or the compression of the sciatic nerve can be caused by spasms or pain of the Piriformis muscle.
The symptoms of sciatica include pain; numbness and tingling that run from the lower back, to the leg and sometimes even to the foot.
Pain is mostly felt while sitting on a car seat or running which can grow manifolds at the time of climbing stairs. This happens when the pressure is applied on the Piriformis muscle directly or when a person sits in the same position for longer periods.
The difficulty lies in its diagnosis as there is no definitive test for Piriformis syndrome. In most cases, it is caused due to repetitive, vigorous activity.
Diagnosis is usually made on the basis of review and patient’s medical history. Physical examination can help understanding the movements that are used to elicit pain to the Piriformis muscle.
Symptoms of Piriformis Syndrome
Most people afflicted with Piriformis syndrome experience acute tenderness in the buttock and pain down the back of the thigh.
Patients may feel mild ache in the buttock and pain at the time of climbing stairs or due to prolonged sitting.
Treatment for Piriformis Syndrome
Avoiding certain positions and activities that trigger pain can help. Consult a doctor or a physical therapist. They can suggest exercises and stretches to reduce sciatic nerve compression.
Doctors and health experts also try Osteopathic Manipulative Treatment, Iontophoresis (in which a mild electric current is used) and injection with Botulinum Toxin (botox).
Anti-inflammatory medications, muscle relaxants, corticosteroid or anesthetic injections are also known to relieve muscle tightness and pain, decreasing spasm. A comprehensive approach should be followed, including nonsurgical treatments like Ice and Heat Therapy.
Piriformis Muscle Stretch
Stretching and exercising the Piriformis muscle is perhaps the best and most effective way to relieve pain along the sciatic nerve. Every treatment for Piriformis syndrome includes focus on carefully stretching the Piriformis muscle.
There are a number of exercises that can help to get a deep Piriformis stretch. Hamstring stretch and hip extensors help decreasing the pain and enabling the patient’s range of motion.
Sitting up straight is the key to a successful Piriformis stretch. However, the exercises can also be performed by lying flat on the floor, with outstretched arms and palms facing the floor. Piriformis stretch can also help relieving the knee and ankle pain.While exercising, it is always advisable to work the entire area and all the connected muscles. Do not overstretch, move slowly and if it hurts, either modify the extension or give a pause.
Make sure that you do not feel pain at the time of stretching. An intense stretch can create an inflammatory response. Hold a Piriformis stretch for 5 seconds in the beginning and then gradually increase it to 15 seconds.
Along with stretching, physical therapy and a regular exercise program can be followed in accordance with patient’s condition.
Deep massage by a specialist or a physical therapist enhances the healing process by increasing blood flow to the affected area and decreasing muscle spasm.
A fully functional and healthy Piriformis is crucial for hip and leg mobility. Our day to day activities can be rigorous. Walking, running, climbing the stairs, cycling and dancing require Piriformis to stay in a healthy condition.
Piriformis syndrome is usually caused by sports and stressful movements of the muscle so it is better to avoid painstaking movements. Warming up correctly before a Piriformis stretch provides added relief. Maintaining a good posture while sitting helps a great deal towards preventing Piriformis syndrome.