The Piriformis Muscle,
The piriformis muscle is a small muscle found deep in the buttocks (behind the gluteus Maximus.
The function of this muscle is to assist in rotating the hip and turning the leg and foot outwards.
Runs diagonally, with the sciatica nerve running vertically directly beneath it (although in some people the nerve can run through the muscles).
Start at lower spine and connects to the upper surface of each femur (thighbone)
Causes of Piriformis Syndrome
The exact causes of piriformis syndrome are unknown. Suspected causes include:
Tightening of the muscles, in response to injury or spasm.
Swelling of the piriformis muscle caused by injury or spasm.
Muscle spasms in the piriformis muscle, either because of irritation in the piriformis muscle itself or irritation of a nearby structure such as the sacroiliac joint or hip
Bleeding in the area of the piriformis muscle.
Any one or mixture of the above issues can affect the piriformis muscle (causing buttock pain) and may affect the adjacent sciatic nerve (causing pain, tingling or paralysis in the back of the thigh, calf or foot).
There is no single diagnostic test for piriformis syndrome producing irritation of the sciatic nerve. The condition is essentially diagnosed by the patient’s symptoms and on a physical exam, and after eliminating other possible causes of the patient’s pain.
Symptoms of Piriformis Syndrome
Most commonly, patients describe acute tenderness in the buttock and sciatica 0like pain down the back of the thigh calf, foot. Typically piriformis syndrome symptoms may include:
Pain down the back of the calf, thigh, and foot (sciatica
A dull ache in the buttock
Decreased range of movement of the hip joint
Pain when walking up stairs or inclines.
Increased pain after prolongs sitting.
Symptoms of piriformis SYdnrome often become worse after extended sitting walking, or running, and may feel better after lying down on the back
Diagnosing Piriformis Syndrome
Diagnosis of Piriformis syndrome is formed on a review of the patent’s medical history physical examination and possibly diagnostic test.
Piriformis Sydney is normally a diagnosis made through a process of ruling out other possible conditions that may be causing the patient symptoms, such as a lumber disc herniation or sacroiliac joint dysfunction.
Typically, the motion of the hip will recreate the pain. The exam will also recognize or rule out other possible causes of the sciatica pain, such as measuring for local tenderness and muscle strength.
A medical history involves an in-depth review of the patients’ symptoms, such as what situations or activities make the symptoms better or worse, the timeframe the symptoms have been affecting you and when if they started slowly or after an injury, and what treatments have been tried.
It will also include a study of conditions that may be in the patient’s family, such as arthritis.
X-rays and other spinal imaging studies cannot identify if the sciatic nerve is being aggravated at the piriformis muscle. However, diagnose tests (such as MRI and X-rays nerve conduction tests ) may be transferred to exclude other conditions that can cause related symptoms to piriformis syndrome.
A dose of anesthetic with or without steroids ma help to confirm if the piriformis muscle is the source of the symptoms. Almost every treatment approach for performing syndrome will include a focus on carefully and progressively stretching the preform muscle.
Some stretching exercises for the piriformis, hamstrings and hip extensors may help decrease the painful symptoms along the sciatic nerve and return the patient;s range of motion.
Almost every treatment approach for piriformis syndrome will include a focus on carefully and progressively stretching the form muscle.
Ther are some ways to stretching exercises for the piriformis, matching and hip extensors may help decries the painful symptoms along the sciatic nerve and return the patient’s range of motion.
Ther ar some ways to stretch on;s piriformis muscle Two simple ways include:
Rest on the back with both feet flat on the floor, and both knees bent. Draw the right knee up to the chest, grabs the knee with left hand pull it towards the left shoulder and hold the stretch. Do the same for each side.
Lie on the back with both feet flat on the floor, and both knees bent. Hold the ankle of the right leg over the knee of the left thigh approaching the chest and hold the stretch. Repeat for each side.
Each piriformis stretch should be done for 5 seconds to start, and gradually progressed to hold for 30 seconds, and recurred three times each day.
Stretching the hamstrings ( the large muscle along the back of each thigh is necessary to alleviate any sciatic pain. There are some ways to stretch the hamstrings.
Place two chairs facing each other. Sit on a chair and place the heel of one leg on the other chair. Bend forward, bending at the hips until a gentle stretch along the back of the thigh is fit, and hold the stretch.
Lie on the back wth both legs straight. Pull on leg up and straighten by holding on to a two that is enclosed behind the foot until a gentle stretch along the back of the thighs felt.
Agin, try to work up to holding each stretch for 30 seconds and repeat three times each day.
Physical Therapy for Piriformis Syndrome
In combination with basic stretching, a comprehensive physical therapy and excise program can be developed for each patient’s individual situation.
Range of motion excises
A physical therapist, physiatrist, chiropractor or another qualified health professional can produce a customized schedule of stretching and range of motion activities to help stretch the muscle and decrease spasms.
Deep massage (manual release) by a physical therapist or other equipped specialist is thought to improve healing by improving blood flow to the area and decreasing muscle spasms.
IN addition to striking and physical therapy, most treatment approaches for promise syndrome will include additional therapies,
Piriformis Syndrome Treatment
Depending on the severity of the patient’s sciatica 0type pain and other symptoms, some treatment options may be prescribed by a health care professional.
A compressive approach to managing piriformis syndrome may include a combination fo the following nonsurgical treatments.
Ice and Heat Therapy for Piriformis Syndrome
At the start of pain, lie in a comfortable position on the stomach and place an ice pack n the painful area for approximately 20 minutes. Repeat as needed every 2 to 4 hours.
Combining a gentle massage with the ice may be helpful. Lie on the stomach and have someone lightly massage the painful area with a large ice cube. If ice is placed on the area immediately to the skin (instead of a cold pack), restrict it to 8 to 10 minutes to bypass an ice burn.
If particular activities are regularly accompanied by increased pain, It may be a good idea to apply ice directly following any physical activity.
Some people find it necessary to alternate cold with heat. If using a heating pad, lie on the abdomen and lay the heating pad on the painful area for up to 20 minutes. Be sure to evade falling asleep on a heating pad as it may lead to skin burns.
For severe sciatic pain from piriformis syndrome, an injection may be part of the treatment.
A local or confined anesthetic corticosteroid may be injected immediately into the piriformis muscle to help decreased the spasms and pain. The idea of an injection is usually to decrease acute to progress in physical therapy.
For persistent piriformis spasms that are resistant to treatment with anesthetic /corticosteroid injections, an injection of botulinum toxin or Botox a muscle weakening agent may be useful. The goal of the injection is to help the muscle relax and contribute to reducing pressure on the sciatic nerve.
The objective with both injections is to help the patient progress with stretching and physical theory so that when the result of the injection is over the muscle will be remain stretched and relaxed.
Electrotherapy for Piriformis Sycamore
The application of electrical restitution to the buttock with a transcutaneous electrical nerve stimulation (TENS) unit or interferential current stimulator (IFC) can assist to block pain and reduce muscle spasms related to piriformis syndrome. In persistent cases, the piriformis muscles can be cut to relieve symptoms, but this is rarely performed.