Piriformis Syndrome

Mary Sisler

What is Piriformis Syndrome?

Pain in the buttock that radiates down the leg is commonly called sciatica. The most common cause for sciatica is irritation of the spinal nerves in or near the lumbar spine. One possible cause of sciatica is piriformis syndrome. Piriformis syndrome can be painful, but it is seldom dangerous and rarely leads to the need for surgery. Most people with this condition can reduce the pain and manage the problem with simple methods, such as physical therapy.
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Body Parts Affected

Affects buttocks, hamstrings, The piriformis muscle begins inside the pelvis. It connects to the sacrum, the triangular shaped bone that sits between the pelvic bones at the base of the spine. The connection of the sacrum to the pelvis bones forms the sacroiliac joint. There is one sacroiliac joint on the left and one on the right of the low back. The other end of the piriformis muscle connects by a tendon to the greater trochanter, the bump of bone on the top side of your hip.

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Signs and Symptoms

Piriformis syndrome usually starts with pain, tingling, or numbness in the buttocks. Pain can be severe and extend down the length of the sciatic nerve (called sciatica). The pain is due to the piriformis muscle compressing the sciatic nerve, such as while sitting on a car seat or running.
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Diagnosis

There is no definitive test for piriformis syndrome. In many cases, there is a history of trauma to the area, repetitive, vigorous activity such as long-distance running, or prolonged sitting. Diagnosis of piriformis syndrome is made by the patient’s report of symptoms and by physical exam using a variety of movements to elicit pain to the piriformis muscle.
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Treatment

If pain is caused by sitting or certain activities, try to avoid positions that trigger pain. Rest, ice, and heat may help relieve symptoms. Iontophoresis, which uses a mild electric current, and injection with botulinum toxin (botox) may be used. Using the paralytic properties of the botulinum toxin, botox injections can relieve muscle tightness and sciatic nerve compression to minimize pain.
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Prognosis

The patient will go through therapeutic sessions that may lead to the betterment of the sciatic nerve. Surgeries may be involved if the patient does not undergo proper treatment and physical care.
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New Terms

Piriformis-

a muscle that arises from the front of the sacrum, passes out of the pelvis through the greater sciatic foramen, is inserted into the upper border of the greater trochanter of the femur, and rotates the thigh laterally.



Iontophoresis-

a technique of introducing ionic medicinal compounds into the body through the skin by applying a local electric current.




The sacroiliac joint-

denoting the rigid joint at the back of the pelvis between the sacrum and the ilium