Piriformis Syndrome: An Introduction
Piriformis syndrome is a little known syndrome under this name, however, the pain that it creates is very real to patients and it can cause significant levels of pain, particularly in the buttocks and then this pain may well transfer down the legs. Patients may also find that they have difficulty moving their hip joint.
The Piriformis Muscle
Piriformis is a relatively small muscle that assists the hip joint in turning and it runs behind the actual hop joint itself. The muscle and its tendon have a close relationship to the sciatic nerve, which is in fact the largest nerve in the entire body. The sciatic nerve and the piriformis tendon actually cross behind the hip joint, meaning that they are close indeed!
When someone has piriformis syndrome it is thought that the muscle tendon of the piriformis may somehow be choking the sciatic nerve, because the muscle and its tendon may be too tight and constricted. Sometimes clinicians refer to the muscle strangling the sciatic nerve.
How Is Piriformis Syndrome Diagnosed?
Piriformis is diagnosed through various means. The most traditional means are through a physical examination (patients often feel a great deal of tenderness in the region of the piriformis muscle. An X-Ray or MRI scan may also be used to determine whether the patients has piriformis syndrome.
Is Piriformis The Same As Sciatica?
Although the pain emanates from the sciatic nerve, there can be other causes of sciatica, so the two are not always the same. Sciatica can be caused by other conditions where there may be a disease in the lumbar spine, for example a herniated disc or even hamstring tendonitis. So when a patient is suspected of having piriformis syndrome s/he will usually be examined closely just to ensure that there is no disease within the lumbar spine.
When it has been established that the pain is from the piriformis and the sciatic nerve, then the condition will be referred to as pirifomis syndrome, as opposed to sciatica.
Treatment Options For Piriformis Syndrome
Treatment options for this condition are varied. Usually patients are encouraged to undergo physiotherapy where stretching techniques and exercises are used to try and free the sciatic nerve, resulting in pain being eliminated.
Patients will usually be asked to carry out these exercises on a daily basis although since they may have contracted piriformis syndrome through exercise, they will be told not to undertake sports activities for a certain period.
If the condition does not respond well to physiotherapy then more invasive procedures may be explored. These may include injecting a steroid and local anaesthetic into the piriformis muscle, so reduce inflammation. Patients may also be prescribed anti-inflammatory medication to reduce the level of inflammation in this area.
Botox can also be used to paralyse/weaken the muscle and thereby reduce pain. (A specific article on the use of botox is also available on this website).
Another treatment option is deep massage as well as the application of heat, so that the area is less painful to the patient.
Where treatments have been tried and repeatedly failed, the most radical option is to operate on the patient and free or release the sciatic nerve by loosening the piriformis muscle and tendon, however, more conservative treatments will always be tried before surgery becomes an option.