Piriformis Syndrome

Piriformis syndrome is a condition in which the piriformis muscle is compressing the sciatic nerve root as it runs down the leg and causes pain in the buttocks and back of the thigh. The muscle is painful and irritated and can be felt at tightness in the buttocks. Piriformis syndrome frequently causes difficulty with sitting and driving.

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Causes of Piriformis Syndrome

Low back issues often cause the piriformis muscle to tighten up as a protective mechanism. Because this muscle lies close to the sciatic nerve, its spasm can mimic sciatic symptoms. Tightening of the piriformis muscle often corresponds to poor abdominal, gluteal and core strength.

  • Lower Back Issues
  • Poor Abdominal, Gluteal, and Core Strength

Symptoms of Piriformis Syndrome

People with piriformis dysfunction commonly have hip/low back pain, numbness, difficulty walking, and pain that can go into the back of the thigh and the upper part of the calf. People may experience difficulty with walking, squatting, sitting, and pain with bowel movements. Piriformis syndrome commonly affects hip range of motion including internal rotation and squatting. Examples of common scenarios that may flare up piriformis syndrome include prolonged sitting at a desk, or long road trips while driving.

Aching pain deep in the buttock and down the posterior thigh may indicate Piriformis Syndrome. Symptoms are often worse when sitting or driving.

  • Hip and Low Back Pain
  • Numbness
  • Difficulty Walking, Squatting, and Sitting
  • Pain with Bowel Movements
  • Impacted Hip Range of Motion
  • Aching Pain in the Buttocks
  • Pain Down the Posterior Thigh

Diagnosis of Piriformis Syndrome

Piriformis syndrome can be diagnosed by your primary care physician, an orthopedic physician, or by a physical therapist. This is a common syndrome that does not require treatment by a primary care provider or specialist.

Diagnosis of piriformis syndrome requires assessment by a medical provider of hip/low back range of motion and strength. As well, palpation of the back of the hip to determine if the piriformis is the muscle causing the pain is necessary. Following diagnosis of the condition, a primary care physician or specialist may prescribe muscle relaxers or steroids. Treatment in physical therapy is also recommended.

Treatment of Piriformis Syndrome with Physical Therapy

Physical therapy and specifically Results Physiotherapy can treat piriformis syndrome through a combination of hands on manual therapy techniques and an exercise program. Myofascial release of the piriformis muscle coupled with a stretching exercise can help relieve tightness and pain directly related to the piriformis. In addition to direct treatment of the piriformis, your physical therapist will address the underlying cause of piriformis syndrome including treating muscle imbalances of the hip and addressing lumbar spine issues.

Piriformis syndrome is not a lifelong condition. Commonly, it takes 4-6 weeks for piriformis syndrome to resolve. Once the pressure in the hip from the piriformis is resolved, progression of strength training takes several weeks to maintain the progress in the hips and core.

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Prevention Tips for Piriformis Syndrome

There are several ways to try to prevent piriformis syndrome from occouring. If you are a desk worker or spend prolonged periods of the day seated, set a timer to get up out of your desk at least once an hour. You can perform piriformis stretches daily to maintain mobility of your hips. As well, performing an exercise program that includes hip and core strengthening can help to prevent piriformis syndrome from developing.

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