This condition mimics the symptoms of other conditions, and some experts feel that it should bear the name of those conditions. Other experts disagree and feel that it should bear the name it does here. The good news is that symptoms can be successfully treated by a range of measures.
The piriformis is a small, flat, pyramid-shaped muscle that originates in the front of the sacral vertebrae and runs through the pelvis to the top of the femur. Its function is to rotate the hip or, in certain positions, to turn it outward.
Normally, the sciatica nerve, which runs from the spine right down to the toes, passes beneath the muscle. But in about 15 to 20 percent of people it runs through rather that under the piriformis, and this makes it more likely that the sciatic nerve can be compressed by muscle spasm or injury (which is thought to be trigger the syndrome in about 50 percent of cases). Yet the nerve can become compressed even if it does not run through the muscle.
Some estimates suggest that women are six times more likely to suffer from piriformis syndrome than men – although there is no accepted explanation of why this should be.
Symptoms for Piriformis Syndrome
Essentially, the symptoms of piriformis syndrome are the same as those of sciatica: an aching, sometimes sharp pain running down the course of the sciatic nerve in the back of the leg, particularly in the buttock area. There may also be pain in the lower back. In addition, a proportion of sufferers from piriformis syndrome notice a reduced range of movement at the hip joint.
What Causes Piriformis Syndrome?
Injury, trauma, and muscle spasms that result from bad posture can all be responsible. And if your sciatic nerve passes through, rather than underneath, the piriformis you are more likely to have these symptoms.
Adopting and maintaining good posture is the only preventive measure, although this may not be an effective if the problem is triggered by an injury to the muscle or an anatomical abnormality.
Figuring out What’s Wrong with your Piriformis
Since it’s debatable whether the condition exists or not, diagnosis is problematic and cannot be supported by tests.
Nevertheless, your doctor is likely to ask for X-rays and possible magnetic resonance imaging (MRI) to rule out any other conditions. But a scan is not always conclusive and diagnosis often relies on your symptoms and the absence of any other identifiable cause for them.
Fixing Piriformis Syndrome
The mainstay of treatment is physiotherapy, in which an individual exercise program will be prescribed. Ultrasound may also provide pain relief. Rest from any activities that may have triggered an underlying injury or spasm and anti-inflammatory medication or injection have also been shown to be helpful.
Surgery to rearrange the piriformis muscle fibres so they don’t impinge on the sciatic nerve can be effective, but is usually only considered when other treatment options have proved ineffective.