What is Piriformis Syndrome?

  • Piriformis syndrome is a rare neuromuscular disorder.
  • Piriformis syndrome is a condition which occurs when the sciatic nerve gets compressed by the piriformis muscle.
  • Piriformis muscle helps in performing movement of the lower body as it is responsible for stabilizing the joint of the hip and lifting and rotating the thigh away from body.
  • Piriformis muscle not only helps while walking and shifting the weight from one foot to another but also maintains the balance.

Types of Piriformis Syndrome:

  1. Primary piriformis syndrome is caused anatomically like in case of split sciatic nerve, an abnormal sciatic nerve path or split piriformis muscle.
  2. Secondary piriformis syndrome is caused by a precipitating cause that includes ischemic mass effect, local ischemia, macrotrauma, and microtrauma.

Causes of Piriformis Syndrome:

  • Piriformis syndrome is caused due to inflammation and irritation of sciatic nerve which often results from spasm, hypertrophy and excessive tightness of piriformis muscle.
  • Traumatic fall in the seated posture may precisely injure the sciatic nerve and may also cause secondary nerve compression because of swelling and gluteal muscle contusion.

Other Causes May Include:

  1. Twisting and bending while picking up an object from the floor.
  2. Carrying heavy objects on the stairs.
  3. Downhill running etc..

Symptoms and Signs of Piriformis Syndrome:

  1. Pain is experienced down side at the back of calf, foot and thigh.
  2. Pain is felt while walking up the stairs or any inclines.
  3. Exacerbation of pain followed by prolonged sitting.
  4. Tingling and numbness in the buttocks.
  5. Pain is also felt in the buttocks.
  6. Painful hip joint movement.

Treatment for Piriformis Syndrome:

  • The initial step taken to treat piriformis syndrome often involves avoiding the activities or sitting postures that are responsible for triggering the pain.
  • Heat, rest and ice may help in controlling the symptoms.
  • Medications like muscle relaxants, injections with corticosteroids or anesthetics and anti-inflammatory drugs are also prescribed to treat piriformis syndrome.
  • Apart from this other therapies like iontophoresis in which mild electric current is used for treating disorders and injection with botulinum toxin are also used in some cases.
  • Surgery is performed in very severe cases where conservative treatments fail to work appropriately.
  • Application of ice to the affected area for about 15 to 20 minutes in every four hours all over the day helps controlling the symptoms.

Physical Therapy (PT) for Piriformis Syndrome

Physical Therapy May Include:

  1. Joint mobilization.
  2. Ultrasound.
  3. Soft tissue massage.
  4. Application of heat and ice.
  5. Orthotics.
  6. Exercises to improve flexibility, strength, pelvic stability and balance, and core stability and endurance.
  7. Electrical stimulation.
  8. Stretching exercises.
  9. Postural training.

Prevention for Piriformis Syndrome:

  1. Maintain good flexibility of the lower extremity and trunk muscles.
  2. Maintain strength of the gluteal and abdominal muscles.
  3. Sitting with feet flat on ground.
  4. Adjusting the seat in order to keep the knees and hips comfortably bent while driving.
  5. Sitting with a wallet in the back pocket must be avoided.
  6. Maintaining perfect posture while standing, lifting, and sitting.
  7. Do not lift with the back bent, preferable to also bend the knee to pick the object.
  8. Keeping the objects close to the body during lifts.
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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