What is Piriformis Syndrome?

Piriformis syndrome causes pain in the buttock which may radiate down the leg. It is due to the sciatic nerve being impinged by a tight piriformis muscle deep in the buttocks.

Symptoms

Piriformis syndrome symptoms consist of tenderness or pain in the buttock muscle which may radiate down the back of the leg into the hamstring muscles and sometimes even the calf muscles.

It is common for pain to initially be confused with a hamstring strain or hamstring origin tendinopathy. However, there will be no area in the hamstrings which is tender to touch. Other signs include reduced range of motion of the hip joint, especially into internal hip rotation is often seen.

Causes

It is usually overuse which causes the piriformis muscle to go into spasm resulting in pressure on the sciatic nerve. The piriformis muscle is one of the small muscles deep in the buttocks that rotates the leg outwards. It runs from the sacrum bone at the bottom of the spine and attaches to the thigh bone or femur roughly near the outside crease of the buttocks.

The sciatic nerve runs very close to this muscle and in around 10% of the population it passes straight through the muscles fibers. If the piriformis muscle becomes tight it can compress the sciatic nerve and cause pain which can radiate down the leg, commonly known as sciatic pain.

It has been suggested that this condition would be better referred to as piriformis impingement due to the impingement of the sciatic nerve. A common cause of piriformis syndrome is tight adductor muscles on the inside of the thigh. This means the abductors on the outside cannot work properly and so put more strain on the piriformis muscle.

Piriformis syndrome Treatment

A successful rehabilitation program for piriformis syndrome consists of two phases.

First reducing pain by relaxing the muscle through ice or heat, EWST Shockwave therapy and stretching.

Then when pain allows, strengthening and loosening the piriformis muscle through a range of exercises and EWST shockwave therapy to help prevent the injury recurring.

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