10/14/2009 - Questions and Answers

Piriformis syndrome

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Piriformis syndrome

Piriformis syndrome is a condition in which the piriformis (a small muscle located deep within the hip and buttocks region) becomes tight or spasms, and irritates the sciatic nerve. This causes pain and may even result in referred pain in the lower back and thigh. The main difference between Sciatica and Piriformis Syndrome is the cause. Sciatica is due to pressure on the sciatic nerve from a bulging or herniated lumbar disc. With Piriformis Syndrome, the irritation of the sciatic nerve is due to spasms or tightening of the piriformis muscle, resulting in pain.
 

Question

I have been diagnosed with piriformis syndrome and have been treating it with conservative care; exercise, meditation, medication, and injections. I am now considering surgery, as it's continued for 34 months! Any advice?

 

Answer

The piriformis syndrome is thought to be responsible for as much as 8% of cases of sciatica; indeed, it may be even more common, as it is often under-diagnosed and under-treated.
The main symptoms are sciatic pain and tenderness in the buttock, with more difficulty when sitting than standing. There are many possible causes: athletic overuse, heavy work, prolonged sitting, and trauma to the region.
Examination by a skilled physician can reveal the movements of the hip joint that cause pain and are diagnostic of inflammation of the piriform muscle. There will be tenderness of the buttock region.
Electromyography (EMG) is helpful in making the diagnosis. There may be signs of impaired function of the posterior tibial and peroneal nerves (nerves supplying the lower leg, behind and at the side).
 

Unfortunately, the piriformis syndrome is a difficult problem to recover from. Some treatment suggestions are:
 

- Physical Therapy - Emphasis on stretching and strengthening the hip rotator muscles
- Rest - Avoid the activities that cause symptoms for at least a few weeks
- Anti-Inflammatory Medication - To decrease inflammation around the tendon
- Deep Massage
 

When these treatments fail, patients may undergo surgery to release, or loosen, the piriformis muscle tendon. This surgery is not a trivial procedure, and is generally considered the last resort if a lengthy period of conservative treatment does not solve the problem. In your case, after 34 months, it seems appropriate to seek surgical advice.

 

Link related to 'Piriformis syndrome'
Piriformis Syndrome: The Big Mystery, or A Pain In The Behind

Created on: 01/04/2005
Reviewed on: 10/14/2009

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Anonymous wrote 2 years 12 weeks ago

Only a doctor specialized in sports can give a 'true' diagnosis of piriformis syndrome. Lumbar spine injuries can mimic piriformis syndrome.

Anonymous wrote 2 years 20 weeks ago

Thanks for the great info on Piriformis Syndrome.

Thanks!

Bryan Daigle

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