Piriformis Syndrome

Piriformis syndrome is a condition where the piriformis muscle (located in the hip) compresses and irritates the sciatic nerve. This results in pain, numbness and general discomfort in the buttocks, lower thighs, legs and lower back (this pain is often referred to as "sciatica"). The sciatic nerve starts in the spine and runs down the back of a person's leg.

The piriformis muscle helps with the lateral rotation of the thigh, and is instrumental for walking since it shifts the body weight to the other side of the foot that is being lifted, thereby keeping a person from falling over.

Causes Of Piriformis Syndrome

Piriformis syndrome can be caused by:

  • Inactive gluteal muscles
  • Prolonged external rotation of the hip, resulting in the shortening of the piriformis muscle (e.g. when a person sits with their hips flexed for extended periods of time)
  • Overuse injury resulting from activities that are performed in the sitting position along with strenuous use of the legs (e.g. rowing, bicycling or sculling)
  • Repetitive forward movements that lead to weak hip abductors, tight adductors and a resultant shortening and contraction of the piriformis muscle
  • Overpronation of the feet, where a person initially makes contact with the ground on the lateral side of the heel while walking or running

When sciatica occurs and there is no clear spinal reason for the pain then piriformis syndrome is often considered as a possible diagnosis.

Symptoms And Diagnosis Of Piriformis Syndrome

Sciatic pain (sciatica) in the buttocks, thighs and lower legs is the predominant symptom of piriformis syndrome.

Diagnosis is clinical in nature, and relies upon the determined exclusion of other causes of sciatica. Physical examination consists of stretching the piriformis muscle in an attempt to provoke sciatic nerve compression. Types of maneuvers used are the Freiberg, Pace, and FAIR (flexion, adduction, internal rotation) exercises. Conditions that these exercises rule out (as the cause of sciatica) are herniated
nucleus propulsus (HNP), stenosis, facet arthropathy and lumbar muscle strains.

MRI, CT, ultrasound, EMG scans and magnetic resonance neurography (an imaging technique) can also be used to exclude conditions that result in sciatica.

Treatment Of Piriformis Syndrome

Our Richmond Hill Chiropractic, Physiotherapy and Massage Therapy center can help treat piriformis syndrome via:

  • Proper stretching exercises and massage therapy that targets the piriformis muscle as well
    as the hamstrings and hip muscles
  • Physical therapy, designed to strengthen the core muscles involved (e.g. abdomen, back, etc.)
    thereby reducing strain on the piriformis muscle
  • Teaching you how to perform these exercises yourself
  • Ice and heat therapy
  • Ultrasound therapy
  • Gait correction (teaching you proper walking and running techniques)
  • Custom orthotics, used for both treatment and prevention

Piriformis syndrome is a debilitating condition that results in pain and discomfort, reducing a person's quality of life by limiting their physical activities.

Fortunately there are things that can be done to treat and prevent this condition.

Chiro-Med Rehab Centre has the necessary knowledge and expertise to start you on the road to recovery today. Try our services: we will have you back on your feet and feeling better, letting you get back to those activities that you love to do!

March 10, 2014

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