Piriformis syndrome is a neuromuscular disorder, which causes pain and numbness in the buttocks and legs. Here is a brief overview about the treatment for this condition.
The medical condition that is characterized by pain in the buttocks and legs, is often diagnosed as sciatica or sciatic neuritis. It is not a disease in itself, but is a set of symptoms, which are caused by certain disorders, like a herniated disc. Sciatica is caused by compression or irritation of the sciatic nerve, which is the longest and widest single nerve; that begins in the lower back, runs through the buttocks and extends to the lower limbs. Apart from pain in the buttocks and legs, the affected person may also experience numbness or a tingling sensation, muscular weakness, and difficulty in leg movements.
The causes for sciatica may vary from one person to another. One such cause is piriformis syndrome, which is a neuromuscular disorder that compresses or irritates the sciatic nerve and causes pain in the buttocks. Such pain may radiate to the thighs and the legs. According to some health experts, such compression of the sciatic nerve can be classified as a form of pseudosciatica or non-discogenic sciatica.
Piriformis Muscle and Piriformis Syndrome
The piriformis is a muscle that connects the sacrum (triangular bone at the base of the spinal column) to the top part of the femur (thigh bone). The muscle that is located deep inside the buttock region, helps in the external rotation of the hip joint, which is necessary for the movement of legs. The sciatic nerve that leaves the spinal column and extends to the legs, runs beneath the piriformis muscles located inside the buttocks.
In some people, the sciatic nerve may run through the piriformis muscle. In both cases, the nerve may get compressed or irritated by the piriformis muscle, which becomes tight or goes into spasms, thereby putting pressure on the sciatic nerve. This condition is called piriformis syndrome.
This medical condition is mainly caused by shortening or tightening of the piriformis muscle, which in turn, is caused by various factors. It could be due to overindulgence in physical activities, like running, walking and exercising. This condition may also be caused by exercising on hard surfaces or uneven surfaces, exercising after a long interval, using ill-fitting shoes while exercising, or by sitting for long periods of time. So athletes, as well as people who lead a sedentary lifestyle, are prone to piriformis syndrome. Other reasons for developing this condition include faulty body mechanics and improper posture. This medical condition can be managed with proper treatment.
Symptoms and Treatment
The most obvious symptom of this syndrome is pain in the lower buttocks. The pain may radiate to the thighs and lower legs. Usually, the lower back pain is concentrated on the hip and the buttocks. It has also been observed that, this type of pain is experienced on one side only. However, some people develop this condition on both the sides.
The affected person may also experience muscular weakness, stiffness, numbness and tingling sensation, and restriction of leg movements. Piriformis syndrome is considered as a cause of sciatica, if all other causes are ruled out. Diagnosis of this syndrome is very difficult and is mostly based on exclusion. Once the spinal causes are ruled out, the most probable cause would be piriformis syndrome. So, any sciatic pain without spinal causes can point towards this medical condition.
Even though, there are many tools (like MRI, X-rays, CT-scans, ultrasound, and anesthetic injections) for diagnosing sciatic pain, they may not be effective for diagnosing piriformis syndrome. All these methods can be used to exclude other causes of sciatic pain. A medical imaging technique called magnetic resonance neurography is found to be useful for detecting the irritation of the sciatic nerve, caused by the piriformis muscle. The affected person may develop tenderness in the area of the sciatic notch; and the pain worsens with physical activities, like walking, running and sitting for prolonged periods.
Piriformis syndrome is often treated with non-steroidal anti-inflammatory drugs and muscle relaxants, in order to provide relief from muscle and nerve pain. Some types of exercises (like stretching exercises) are also recommended, to strengthen this muscle and to relieve irritation of the sciatic nerve. It is advisable to avoid strenuous physical activities, like running, bicycling and rowing. Physical therapy and massage are also recommended for some of the patients. Alternate use of cold and hot compresses is suggested as a part of treatment. Hot compresses can be replaced with ultrasound.
For some others, gait correction is suggested for relief from this disorder. If all these treatment options fail, therapeutic injections are used. Such injections are really complicated, as the piriformis muscle (which is to be injected with drugs) is seated very deeply. In rare cases, doctors may also recommend surgery, which are mostly successful.
It has been observed that, most patients get relief from this disorder through conventional piriformis syndrome treatment options, like physical therapy, use of anti-inflammatory drugs, and other techniques. While injections are rarely used as a treatment option for this condition, surgery is considered the last resort.
Disclaimer: This article is for informational purposes only, and should not be used as a replacement for expert medical advice. Visiting your physician is the safest way to diagnose and treat any health condition.