What Is Piriformis Syndrome? Piriformis syndrome refers to irritation of the sciatic nerve as it passes through the piriformis muscle located deep in the buttock. Inflammation of the sciatic nerve, called sciatica causes pain in the back of the hip that can often travel down into the leg.
How Does It Occur? The piriformis muscle is located deep in the buttock and pelvis and allows you to rotate your thigh outward. The sciatic nerve travels from your back into your leg by passing through the piriformis muscle. If the piriformis muscle is unusually tight or if it goes into spasm, the sciatic nerve can become inflamed or irritated. Piriformis syndrome may also be related to intense downhill running.
What Are The Symptoms Of Piriformis Syndrome? You have pain deep in your buttock that may feel like a burning pain. The pain usually travels down across your lower thigh. Your pain may increase when you move your thigh outward, such as when you are sitting cross-legged.
How Is It Diagnosed? Your doctor will talk to you about when your symptoms began. Since your sciatic nerve begins in the back, it can be irritated from a back injury, such as a herniated disc. Your doctor will ask if you have had any injuries to your back to see if the sciatic nerve is irritated there. He or she will examine your hip and legs and move them in specific directions to see if movement causes increased pain.
Your doctor may order x-rays, a computed tomograpgy (CT)scan, or a magnetic resonance image (MRI) of your back injury. There are no x-ray test that can detect if the nerve is being irritated at the piriformis muscle.
What Is The Treatment For Piriformis Syndrome? Treatment may include:
- 1. Placing ice packs on your buttock for 20 to 30 minutes every 3 to 4 hours for the first 2 to 3 days or until the pain goes away.
- 2. Rest.
- 3. Taking prescribed anti-inflammatory medications or muscle relaxants.
- 4. Learning and doing stretching exercises for the piriformis muscle.
When Can I Return To My Sport Or Activity? The Goal of rehabilitation is to return you to your sport or activity as soon and as safely as possible. If you return too soon you may worsen your injury which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your sport or activity will be determined by how soon the nerve recovers not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment the longer it will take to safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:
- 1. You have full range of motion in the injured leg compared to the uninjured leg compared to the uninjured leg.
- 2. You have full strength of the injured leg compared to the uninjured leg.
- 3. You can jog straight ahead without pain of limping.
- 4. You can do 45-degree cuts first at half-speed then at full-speed.
- 5. You can do 20- yard figures-of-eight, first at half-speed, then at full-speed.
- 6. You can do 90-degree cuts, first at half speed, then at full speed.
- 7. You can do 10-yard figures of eight, first at half-speed, then at full-speed
- 8. You can jump on both legs without pain and you can jump on the injured led without pain.
How Can I Prevent Pirifromis Syndrome? Piriformis syndrome is best prevented by stretching the muscles that rotate your thigh inward and outward. It is important to have a good warm-up before starting your sport or activity.
Piriformis Syndrome Rehabilitation Exercises: You may do all these exercises right away.
1. Piriformis stretch: Lie on your back with both knees bent and the foot on your uninjured side flat on the floor. Rest the ankle of your injured leg over the knee of your uninjured leg. Grasp the thigh of your uninjured leg and pull that knee toward your chest. You will feel a stretch along the buttocks and possibly along the outside of your hip on the injured side. Hold this for 30 seconds. Repeat 3 times.
2. Standing hamstring stretch:Place the heel of your injured leg on a stool about 15 inches high. Lean forward, bending at the hips until you feel a mild stretch in the back of your thigh. Hold the stretch for 30 to 60 seconds, then relax repeat 10 times do 3 sets.
4. Partial curls: Lie on your back with your knees bent and your feet flat on the floor. Clasp your hands behind your head to support it. Keep your elbows out to the side and don't pull with your hands. Slowly raise your shoulders and head off the floor by tightening your abdominal muscles. Hold this position for 3 seconds. Return to the starting position for 3 seconds. Repeat 10 times. Build up to 3 sets.
5. Prone hip extension: Lie on your stomach. Tighten up your buttock muscles and lift your right leg off the floor about 8 inches. Keep your knee straight, hold for 5 seconds, and return to the starting position. Repeat 10 times. Do 3 sets on each side.
All material provided is designed for information purposes only and should not be used to replace the care of a health care professional. Do not rely on any of the information for diagnosis or treatment. It is recommended that you visit a qualified health care professional for individual and personal attention.
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