Piriformis Syndrome
Piriformis Syndrome is a result that comes up often when our patients search online to find a diagnosis that explains their symptoms. So today I thought let’s dive a little deeper into it. I hope that this can serve as a practical resource for you and that you find it useful. We will answer 3 simple questions.
What is Piriformis Syndrome?
What can you do about it
What else it could be
How can we help you?
What is Piriformis Syndrome?
If you do a quick google search you’ll get this answer which does sum it up pretty well.
Piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle also can irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot
What is less commonly known is that the issues of the piriformis that effect the sciatic nerve also effect another smaller nerve right near by. The Posterior Femoral Cutaneous Nerve. This second nerve gets much less attention but may actually contribute to your symptoms if they are mostly in the posterior thigh.
What can you do about it?
Most of the common solutions for Piriformis Syndrome involve attempting to lengthen the piriformis. The options range from home stretches to self massage. All can be helpful for providing temporary relief but need to be sustained to achieve sustained relief.
Below is an example jpg from Spine-Health.com. You can click on the image to be taken to their site to view the full sheet.
When I am asked I usually suggest a modified pidgeon pose activity. I prefer to use it as a strengthening exercise where possible and perform 10 repetitions of it. If you experience any other symptoms than a stretching sensation, you should stop immediately and speak to your chosen health professional.
This exercise uses a raised surface instead of the floor. If you can get into this position you can try to press your raised knee into the table. If possible, with enough force to take your weight and lift off the table a little.
You can cheat by using the stabilising foot on the floor to assist. Once you’re up, just slowly lower yourself down. You might want to lean forward at first to make it a little easier.
Remember the golden rule: it must be painfree
What else could it be?
In a clinical setting Piriformis Syndrome is a diagnosis of elimination. In most cases, the examination findings that are positive and suggestive of PS can also be positive in other conditions too.
When I am asked what else could it be I usually suggest the 3 structures I treat most often when I find Piriformis Syndrome symptoms.
Sciatic nerve
Posterior Femoral Cutaneous Nerve
Lumbar Spine
How we can help
In my clinic we have unique treatment techniques that directly target the sciatic nerve and the posterior femoral cutaneous nerve. These techniques can be uncomfortable but the discomfort is often short lived. Many people have found them helpful in achieving relief from their symptoms.
When the lumbar spine causes symptoms similar to Piriformis Syndrome it can be more concerning. It may involve pain from the discs, nerve roots, joint capsules or muscles. The scope of these causes and what to do about them is worthy of a blog post of it’s own.
That is to say that when it we do treat the lumbar spine we use any combination of spinal adjustments, soft tissue therapies, shockwave therapy and exercises. Whichever option suits the person and the problem.
If you’d like to see if we can help you, please click the ‘book now’ button and we’d be more than happy to see you in our clinic.
