Piriformis Syndrome
Piriformis syndrome is a condition affecting the piriformis muscle and is familier to the physiotherapists at Core Body Clinic. Adrian has researched this syndrome using ultrasound and knows what a tricky condition it can be to diagnose and treat. It describes pain emanating from either the left or right buttock and may cause pain to be referred into the posterior thigh, calf and/or pins and needles in the leg or foot.
It is common in runners, latter stages of pregnancy, may be due to weak muscles around the hip and pelvis, and can in occur persons suffering from sciatica or sacroiliac pain (SIJ). The piriformis muscle sits deep within in the pelvis emerging from the front of the sacrum (inside the pelvis) and extending to the Greater Trochanter (knobbly bit of bone on the side of the upper thigh). It is a very deep muscle.
The diagnosis is very popular but must be differentiated from other causes of buttock pain. It is often associated with neural irritation of the sciatic nerve or a disc prolapse. It can also occur with irritation or dysfunction of the Sacro-iliac joint. To find it place a finger on the Greater Trochater and then another finger on the the opposite little dimple just on the lower back, then finding the mid point you will come to the depression in front of the Greater sciatic notch. Here will be the belly of the piriformis. It is 'deep' - and covered by the Gluteal muscles. We know this to be a reliable test - We invented it!
With the right treatment, advice and excercise it is a condition that benefits from physiotherapy!
Symptoms
We suggest if there has been repeated treatments with little change then one should question the diagnosis.
Pain in the buttock
deep and aching
compression of the sciatic nerve cuases pain down the leg
possible pins and needles or numbness
pain on compression; pain on sitting
alleviated when reducing weight through buttock
weakness of buttock muscles
worse with running
prolonged sitting
stretching
Stretching with palpation of the muscle often causes symptoms.
Causes
Weakness of the hip or pelvic muscles; poor conditioning around the pelvis; inflexibility of the lower back; irritation of the sciatic nerve; trauma; poor training habits for runners; prolonged postural alteration; disc prolapse.
Treatment
Acupuncture/dry needling is useful for symptom control and muscle spasm reduction
spinal manipulation of the lumbar spine and/or pelvis
Correction and pacing of activity
Correction of sport and exercise habits
Strengthening of pelvic and 'core' muscles
Recovery can be swift once seen by a physiotherapist
Unsure if physiotherapy is for you? Get in touch and ask the experts!