The Piriformis muscle is located in the buttocks area, underneath the gluteus maximus. It’s one of the muscles that helps rotate the thigh bone outward, like you do when you cross your ankle over your knee. The muscle runs from the tail bone and attaches at the hip bone.The sciatic nerve is a major nerve that begins in the low-back area and travels down the back of the thigh and continues down, branching off in the lower leg and foot. The sciatic nerve usually runs directly through the Piriformis muscle, although it may lie above or under the Piriformis.
The cause of Piriformis Syndrome is not entirely clear and may be a result of several different things. It is often associated with sacroiliac (SI) problems. Trauma, such as falling on the buttocks may incite the symptoms. Extended sitting can be a factor, as in the case of professional drivers or office workers. Other problems, such as hip bursitis, back strains, or gluteal tendonitis may bring on the condition.
Symptoms include pain and tenderness in the buttocks area. The problem may be on one or both sides. Sitting is often uncomfortable. Walking, running, and climbing or descending stairs is often painful. In some cases radiating pain may shoot down the back of the thigh and into the lower leg because of irritation to the sciatic nerve.
There are many treatment options for Piriformis Syndrome. Moist heat can help relieve and control pain. Ultrasound may be beneficial since it is a method of deep heating. Certain therapeutic exercises may greatly help to recondition the muscle. There are several stretches for the muscle that can help relieve the tightness. Avoidance of irritating factors is crucial. Manual techniques such as soft tissue mobilization are often helpful. In severe cases, anti-inflammatory injections may be needed.
With proper treatment and follow through, this condition can be resolved. In some cases it will resolve quickly, while in others it may be a lengthy rehabilitation. For more information consult your physical therapist.
Post written by Travis Rohner, DPT