Piriformis Syndrome - What is it and how to treat it

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What is Piriformis Syndrome?
  • Piriformis Syndrome is an overtight Piriformis muscle which then presses on the Sciatic Nerve causing pain and tightness in the buttock sometimes with tingling and burning sensations which can radiate down the back of the leg.  Often people will assume that they have Sciatica due to the similarity of symptoms.

 

Causes of Piriformis Syndrome?
  • It is usually caused by overuse of the muscle which causes an over tightening of the Piriformis Muscle resulting in pressure on the sciatic nerve.
  • Tight muscles on the inside of the leg (adductor muscles) creating tightness can also inhibit the correct movement of these muscles thereby putting more strain on the Piriformis Muscle.

 

Treatment
  • In the intial stages the goal is to reduce pain.  Ice can help reduce muscle spasm and nerve pain in the first day or so.  However longer term heat application is more beneficial as it helps bring fresh blood to the area and helps relax this muscle.
    • Heat should not be applied if there is a suspected muscle tear.
    • If heat is used then it should be applied for 15/20 minutes 2-3 times per day.
    • Do not apply heat pads directly to the skin.
  • Massage
    • Light massage can help release muscle tension and active techniques can be used to stretch the muscle.
    • Massage on the muscles around the Glutes can be beneficial as compensatory tension can arise through changed movement due to pain.
    • At the very least two to three sessions at the start of rehabilitation is a good idea. As the condition improves massage can be performed deeper, but the deeper the massage the longer it should be left between sessions as the muscle will need to recover in the same way as it does with heavy strengthening exercises.
  • Stretching
    • Hold this stretch for around 20-30 seconds and repeat as often throughout the day as possible (2-4 x recommended).

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  • Foam Rolling
    • This can help release the Piriformis Muscle.

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  • Strengthening
    • Strengthening  should be done on a daily basis immediately followed by stretching exercises as the muscle will be more likely to relax into a stretch if it has been worked and warmed up.

    • The more that you sit then the more often this exercise should be done.  At least 3 times a day.

    • Strengthening the piriformis muscle itself and also the other hip abductor muscles can be helpful in preventing piriformis syndrome recurring.

    • Clam exercise - Lay on your side, bend the knees and position them forwards so that your feet are in line with your spine.

    • Make sure your top hip is directly on top of the other and your back is straight. Keeping the ankles together, raise the top knee away from the bottom one. Work until you feel the muscle starting to fatigue but do not overdo it especially in the early stages. Slow controlled movements are important.

 

As always if you are unsure of your condition then please seek advice from a professional.