Do you have lower back or hip pain? Your piriformis muscle could be to blame. Approximately 200,000 people are diagnosed with piriformis syndrome each year. This condition affects the muscle that travels through the gluteal region and connects your sacrum to your hip bone. When this muscle is damaged, it can cause pain, uncomfortable sensations, spasms, and limited mobility.

 

What Is Piriformis Syndrome?

Your pelvis is surrounded by a series of interconnecting muscles. When these muscles function responsively, contracting and relaxing, they keep the other structures in this region in check. If any muscles in this network are tight, they become shorter than they are supposed to be and don’t respond reflexively to movement. They may also pull on a joint, ligament, or other muscle. Therefore, piriformis syndrome is generally a muscular disorder that can also be associated with spinal disc problems.

One of the main reasons this condition causes so much pain is that the sciatic nerve runs over or under the piriformis muscle. In some people, the nerve runs through the muscle. As the muscle swells or tightens, it puts pressure on the nerve, causing burning or shooting pain along the length of the sciatic nerve.

 

What Causes Piriformis Syndrome?

What is the leading cause of piriformis syndrome? It differs for everyone. In some cases, anatomical anomalies, such as different leg lengths or scoliosis, can cause piriformis syndrome. But the condition can also develop from overuse, prolonged sitting, prior hip surgery, sports injuries, and scarring.

One thing many people do that causes a tight piriformis is slouching. When your lower back is rounded and your hips are rotated outward, your piriformis muscle shortens. Sitting too much also weakens the glutes, which can make piriformis pain worse. With the average American adult sitting for six hours each day, many people could be putting themselves at risk of developing this medical issue.

Piriformis syndrome can also be caused by repetitive motions and injuries. Many long-distance runners overtrain, fatiguing the muscle without giving it enough recovery time and causing inflammation. Overusing surrounding muscles without warming up, stretching, and recovering correctly can also exacerbate the issue.

 

Symptoms of Piriformis Syndrome

The symptoms of piriformis syndrome can mimic other medical conditions. If the condition isn’t diagnosed accurately, you may not be able to treat it effectively. In fact, piriformis syndrome is often misidentified. It may be confused with a herniated disc, sciatica, or high hamstring tendinitis.

The piriformis syndrome pain pattern follows a similar path for everyone:

  • Early stages: Numbness, pain or tingling in the buttocks; low back or sciatic pain
  • Later stages: Pain extends down the sciatic nerve to the foot; muscle and leg pain becomes severe.

 

How Is Piriformis Syndrome Diagnosed?

It’s essential to identify the problem correctly in order to treat it correctly. Medical professionals can test for piriformis syndrome in multiple ways.

  • Side-lying test for piriformis: Also known as the FAIR test, this evaluation involves stretching and manipulating the affected leg while the patient lies on their side.
  • Seated test for piriformis: The patient crosses the ankle of the affected leg over the other knee while sitting upright in a chair with both feet on the ground. 
  • Active test for piriformis: Assesses pain while the patient is actively abducting the hip.
  • Straight leg raise test: Also called the Lasegue test, this assessment helps to detect disc herniation that might accompany piriformis syndrome.

Can Piriformis Syndrome Be Treated?

Rest is essential for healing piriformis syndrome, although giving the muscle a break probably won’t fix the problem completely. Treatments that focus on aligning your pelvis, relaxing the muscles, and reducing inflammation are often used to relieve piriformis pain and prevent it from returning.

You can use the following methods at home:

  • Rest: It sounds simple, but your busy lifestyle might prevent you from resting as much as you should. Avoid the activities that aggravate your symptoms. You may still be able to walk, run or train gently. Take time off from doing lunges, running up hills, jogging on uneven surfaces, or climbing stairs. It could take up to six weeks or longer for this type of injury to heal.
  • Piriformis syndrome massage: Any time you loosen the muscles surrounding the sciatica, you’ll relieve some pressure. Massage and foam rolling also help break up the connective tissue that pinches the nerve. Plus, it enhances circulation in the tight muscle and aids healing.
  • Ice: Applying ice to the muscle relieves inflammation and pressure on the sciatica. Even though the pain might extend down the back of your leg and up your low back, you should apply the ice to the affected buttock.
  • Physical therapy: Several stretches and exercises can improve your mobility, reduce pain, balance out your muscles and enhance healing. Rehabilitation techniques help you regulate your balance, coordination, strength, and flexibility.
  • Piriformis syndrome chiropractic care: Regular and acute chiropractic care helps you maintain alignment and treat soft tissue restrictions so that your muscles, ligaments, tendons, and tissues function in harmony.

Some tips for alleviating piriformis pain include:

  • Sit in a firm chair that elevates your hips slightly.
  • Change position and move around at least every 20 minutes.
  • Try a standing desk.
  • Warm up with glute-activation exercises before you run or work out.
  • Avoid over-training or running on slanted surfaces.
  • If you feel pain during an activity, stop what you’re doing.

At the Bergen Chiropractic and Sports Rehabilitation Center, our chiropractic team, led by Dr. Gregory Doerr, follows the highest and most professional medical standards to provide superior chiropractic help. Our mission is to provide unparalleled patient care and services in a comfortable healing atmosphere. Contact us to learn more about our chiropractic services!