Piriformis Syndrome

A burning pain shoots down your leg, fast and severe as an electric shock. You hold still, hoping it will go away. The pain starts to subside, and, in relief, you unfreeze... only to be stunned by another burst of pain.

Sound familiar? This is a symptom often associated with sciatica, the irritation or dysfunction of the great sciatic nerve. Since sciatica is usually caused by a disc herniation or other spinal problem, you may be disheartened at the prospect of long-term care and treatment.

Here's the good news: your pain might be from a completely different cause. It might be piriformis syndrome.

The piriformis muscle (sometimes spelled pyriformis muscle) attaches to the back of your thigh bone under your hip. It is one of several muscles that rotate your thigh outwards, as when kicking a soccer ball or relaxing in an easy chair. It can be compressed by objects carried in your hip pocket, causing wallet sciatica.

But what sets this tiny muscle apart from its neighbors is a unique quirk: a small percentage of people have a variation in the structure of this muscle. In about 20% of people, the sciatic nerve passes directly through the piriformis muscle. In almost everyone else, the sciatic nerve goes around the muscle on its way from your spine to your foot.

In these individuals, an hypertonic or contractured piriformis muscle may cause irriation to the sciatic nerve. This pain runs up and down the sciatic nerve, mimicking a classic form of sciatica. The diagnosis of piriformis syndrome is sometimes made in those cases of sciatica where there is no disc problem in the spine. Although elusive, piriformis syndrome can be verified electrophysiologically.

How We Can Help Your Piriformis Syndrome

Clinically, piriformis syndrome is often seen in conjunction with sacroiliac dysfunction. A good evaluation of your sciatic pain should incorporate a thorough orthopedic examination of your hips and sacroiliac joints. Also, a proper study of your biomechanics should also reveal whether your hip problems are caused by issues in your knees, ankles, or low back. Dr. Johnson will search for the cause of your sciatica.

If your diagnosis is piriformis syndrome, there are many ways in which you can find relief in the chiropractic office. The most important step is to ensure that your muscles, bones, and nerves are maintaining a proper relationship to each other. This can often be corrected by the chiropractic adjustment. The gentle Activator Methods adjustment is excellent at not causing additional aggravation to your already painful legs.

Dr. Johnson will also demonstrate and perform appropriate stretches and exercises for you. Not everyone can perform some of the more popular piriformis stretches, because they require a high amount of flexibility. Dr. Johnson will tailor your rehabilitation to your abilities and desires. He will also monitor your activity level during your treatment.

Additional therapies that may help reduce your pain include cold laser therapy, ultrasound therapy, electric stimulation therapy, and muscle relaxants. Be sure to ask Dr. Johnson about these alternatives when scheduling a consultation.

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Causes

- prolonged sitting
- prolonged external rotation of the thigh, as when sitting in a car for too long
- compression of piriformis muscle and other external rotators of the femur
- overuse of gluteal and piriformis muscles
- poor posture
- gait problems
- sudden adoption of a vigorous exercise routine
- past trauma