Diagnosis: Piriformis Syndrome
What is Piriformis Syndrome?
Piriformis syndrome is a condition that causes a long nerve running through the back of the leg, the sciatic nerve, to become irritated by a small muscle in the back of the hip (piriformis muscle) 1.
Symptoms of Piriformis Syndrome
Those with Piriformis Syndrome usually experience one or more of the symptoms below1, 2:
- Pain usually in one buttocks – however, pain may also be present in both
- Pain may radiate down the back of the leg
- Feeling of tightness, tingling, weakness, or numbness going down the back of the thigh and calves
- Pain made worse by: walking, running, prolonged sitting
- Sitting lopsided to avoid putting pressure on the painful buttocks
How is it Diagnosed?
There is not set way to diagnose piriformis syndrome. However, in most cases an in depth interview reveals a history of repeated vigorous activity such as long distance running or sitting for long periods of time2. The most common way to diagnose piriformis syndrome is through ruling out other possible conditions such as a lower back disc herniation and hip joint pain2. This is done through a series of tests including: checking movement at the hips and legs, a straight leg raise and pushing the knees out to the side with the physiotherapist providing resistance3.
What Causes Piriformis Syndrome?
The sciatic nerve runs from the lower back all the way down to the foot, and in some people is located between the small piriformis muscle. However, when doing prolonged and repeated movements such as running and sitting for a long time, the nerve becomes compressed and irritated from sliding on the muscle1. This repeated sliding movement causes a build up of friction and the nerve becomes inflamed, leading to the sharp pain and tingling felt down the leg1.
How is Piriformis syndrome treated?
Once a diagnosis has been made and upon discussion with the physiotherapist, treatment for piriformis syndrome can include any of the following:
- Pelvis and spine re‐alignment techniques3
- Moving the hip joint to help gain back pain free movement3
- Massage to help reduce pain and spasm in the piriformis muscle1
- Stretching program for muscle length and flexibility2
- Hip strengthening exercises to help stabilise the hip, pelvis and the spine2
- Strategies to help prevent or reduce symptoms associated with piriformis syndrome such as; running posture2
It is important to note that these treatment methods are to be specially tailored to your lifestyle and upon consultation with the physiotherapist an adequate treatment plan can be administered1.