Treatment for Piriformis Syndrome

Posted on 01. Dec, 2010 by in Piriformis Syndrome

Piriformis syndrome is a condition that occurs when the piriformis muscle located in the groin area of the human body becomes irritated or inflamed in some way causing swelling or spasms. The swelling or spasms can then lead to compression or irritation of the sciatic nerve located right below it. When this occurs you would have symptoms of sciatica, including pain, numbness, or weakness in the lower back, buttock, and legs.

The piriformis muscle is located very deep inside the pelvis and is connected to the sacrum, a bone that sits in your pelvis and in the base of your spine. The piriformis muscle is a very small muscle but because it passes so close to the sciatic nerve it has the potential to cause severe pain if injured. In a small number of people the sciatic nerve actually passes directly through this muscle.

Piriformis Syndrome Symptoms

Piriformis syndrome can be very difficult to diagnose and oftentimes is missed because it shares very similar symptoms with other conditions. For this reason the correct diagnosis for your pain may not be found right away. Listed below are some of the commonly reported piriformis syndrome symptoms.

  • The most pronounced symptom you will experience is chronic pain that is located in your buttocks and surrounding areas.
  • You may also begin to experience numbness or a feeling of pins and needles in your lower back, buttocks, thigh, calf and foot.
  • Your pain, numbness, and tingling would increase if you perform any activities such as running, sitting in a certain way, walking, or squatting. People suffering from piriformis syndrome find these activities intolerable to perform for any length of time.
  • You may notice a decrease in your mobility as you find it harder to walk without pain.

Piriformis Syndrome Causes

  • This type of injury is often seen in golfers, skiers, runners, and skaters because of the leg and hip joint movements that are needed to perform the activities.
  • A trauma or injury that stresses the area surrounding the piriformis muscle
  • Weak abductor muscles and strong adductor muscles can cause an imbalance in the area stressing the surrounding structures.
  • Sitting lopsided for any length of time. This could be a result of a wallet in your back pocket that is too large or anything that would tip the body to one side.
  • Repetitive movement of the leg and hip joints. This could be from a leisure activity, but it can also be work-related.

because this type of injury can present with symptoms that are very similar to other conditions, if you are experiencing any back pain at all it is always best that you speak to your doctor. It is very easy for you to go to the Internet to search for information. But even if you have found a condition that presents with symptoms similar to yours, it does not mean you are suffering from that condition. Only a doctor can properly diagnosis your condition and guide you to move forward with a treatment plan that will reduce your pain and allow you to have an active and full lifestyle.

Treatment for Piriformis Syndrome

Rest
Most people suffering from this condition will benefit from a small amount of rest, maybe 2-3 weeks, during which they limit their activities to those that will not stress the piriformis muscle. This means no running or intense workout!

By resting, it is possible for the swelling in your piriformis muscle to subside and you may see a reduction in your pain. If this treatment works for you it is best that you do not just jump right back to the activities you were doing previously as your pain may come back. Resume your activities gradually to make sure you do not reinjure the area.

Medication
Over-the-counter or prescription medications that are non-steroidal anti-inflammatory and prescription muscle relaxants can be used to reduce pain, inflammation, and muscle spasms.

The most commonly used over-the-counter non-steroidal anti-inflammatory drugs (NSIADs) are Ibuprofen (eg, Advil and Motrin) and Naproxen (Aleve). If you need muscle relaxants you will need to get a prescription from your doctor. Soma (carisoprodol) is the most commonly prescribed medication for piriformis muscle spasms; it works by blocking the nerve impulses to your brain.

Exercise and Stretching
One of the best forms of treatment for piriformis syndrome are exercise and stretching. Gentle stretching the piriformis muscle helps to reduce the pain you are feeling and increase your range of motion. Once you are feeling better you can also begin to incorporate exercises into your routine to help keep your body conditioned while you recuperate from your injury. These exercises and stretches should be done only with the permission of your doctor or physical therapist.

Posture Changes
If your piriformis syndrome is caused by improper posture, correcting your posture should show signs of improvement in as short as a week.

Epidural Steroid Injections into the Area Affected
An injection of an anti-inflammatory medication directly into the area that is affected can help reduce pain and inflammation much better than oral medications. Te injections can reduce your pain and inflammation for up to 3 months. This should give you plenty of time to exercise and stretch the muscle, which offers you the best chance of long-term relief.

Surgery
Surgery should only be your last option after all other treatments fail. You should give yourself 6-12 weeks for the other treatments to show results before deciding to consider surgical options. There are 2 different types of surgery that can be performed at this point: one is performed to detach the piriformis muscle from the hip bone and the other is used to cut right through the piriformis muscle to remove any pressure that may be on the sciatic nerve.

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