Piriformis Syndrome (Sciatica)
Piriformis is the muscle that is flat and looks like a band and present near the top of the hip at the buttock area. This muscle helps in stabilizing the hip and helps in rotation of the hip away from the body. Spasm or tightness of the piriformis muscle can compress the nerves and causes pain and discomfort. It can also compress the sciatic nerve and may cause sciatica. Buttock area feels the pain.
Causes
- Too many exercises can cause overuse injury to the piriformis muscle
- Inactivity or sitting for a long duration
- Lifting heavyweight
- Excessive climbing of stairs
- Repetitive use of legs( long walks, running, etc.)
- Direct injury to the piriformis muscle( Sudden hip twist, fall, direct hit, accident, etc)
Symptoms
- Pain and discomfort at the buttock area
- Pain can radiate down in the back thigh and legs
- Tingling sensation and numbness in the buttock area and can radiates at the back of the thigh and legs
- Tenderness at the buttock area
- Sitting is difficult and you can feel discomfort in sitting
- Pain increases with a long time of sitting
- In severe cases, it interrupts your daily routine activities
Diagnosis
- Patient’s history and symptoms along with physical examination by the doctor
- X-ray performed to check the joint structure and to check if there is any bony problem
- MRI is more specific and also shows the nerve compressions and soft tissue
- CT scan may be prescribed if required
Treatment
-
- Take rest and avoid activities that are aggravating your pain
- Use ice and hot fermentation one by one
- Medications: Pain killers to manage the pain
- Physiotherapy: Stretching and exercises to improve the flexibility and strengthening of the piriformis muscle
- Electrical modalities like TENS (transcutaneous electrical stimulation)
- In severe cases, corticosteroids injections are given to reduce the pain and inflammation
- After all this treatment if there is no relief then surgery may be required to remove the compression from the nerve
