Piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle can also irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (similar to sciatic pain).                              

CAUSES

Some common causes of piriformis syndrome include:

  • Overuse from excessive exercise 
  • Running and other repetitive activities involving the legs 
  • Sitting for extended periods
  • Lifting heavy objects 
  • Extensive stair climbing 

Injuries can also damage the muscle and cause it to press down on the sciatic nerve. Typical piriformis injury causes include:

  • A sudden twist of the hip
  •  Abad fall
  •  A direct hit during sport
  •  A vehicle accident 
  • A penetration wound that reaches the muscle

SYMPTOMS

 piriformis syndrome symptoms may include:

  • A dull ache in the buttock
  • Pain down the back of the thigh, calf and foot (sciatica)
  • Pain when walking up stairs or inclines
  • Increased pain after prolonged sitting
  • Reduced range of motion of the hip joint

TREATMENT

Piriformis syndrome treatment may include: 

  • A few days of rest.
  • Home exercises to stretch or strengthen the piriformis.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Massage, as complementary medicine.
  • Medications that relax the muscles.
  • Piriformis syndrome physical therapy that focuses on stretching and strengthening the piriformis.
  • Steroid injections.

Piriformis syndrome surgery is usually not recommended unless all other therapies fail. Surgery for this condition may involve removing scar tissue or other sources of pressure on the nerve.

PREVENTION OF PIRIFORMIS  SYNDROME 

To prevent piriformis syndrome, including recurrent (repeat) episodes, consider some of the following strategies:

  • Exercise regularly to keep your muscles healthy.
  • Focus on good posture, especially when sitting, driving or standing.
  • Lift things properly by bending your knees and squatting, making sure to keep your back straight. 
  • Keep objects close to your body, and don’t twist while lifting.
  • Warm up before physical activity and stretch after.
  • When you must sit for long periods of time, take breaks by standing, walking or stretching.

TAKE CARE OF ALL THINGS WHILE HAVING PIRIFORMIS SYNDROME

If you have piriformis syndrome, certain adjustments can help you manage the symptoms when they occur:

1. Avoid activities that trigger piriformis syndrome.

2. Massage deep into the tissue of the hips and buttocks.

3. Get up from your chair regularly. Stand, walk and stretch. This is especially important for people who sit to work, such as professional drivers and desk personnel.

4. Take NSAIDs according to package directions to reduce swelling.

5. Try cold packs or heat, depending on what works for you. Icing the area several times a day for 15 minutes can reduce swelling. Heat (such as a heating pad) can loosen a tight muscle.

6.Stretch the piriformis and surrounding muscles. For example: Lie on your back, then pull one knee toward your chest. Hold it for five to 30 seconds, then do the other leg. Another example: Stand, hinge at your hips and let your head and hands fall toward the floor. This will stretch through the back of the legs and buttocks.

EXERCISE FOR  PIRIFORMIS SYNDROME


1. Knee-to-shoulder piriformis stretch                                                                            

Lie flat on your back with your legs straight.

Lift your leg and bend your knee. 

With your opposite hand, pull your knee toward your opposite shoulder.

Hold for 30 seconds.

Do this on each side three times, twice a day.

2.Ankle-over-knee piriformis stretch

Lie flat on your back with both knees bent.

Cross your ankle over your opposite knee.

Grab the back of your thigh area behind your opposite knee.

Gently pull your thigh straight toward your chest.

Hold for 30 seconds.

Do this on each side three times, twice a day.

3. Bridge

Lie flat on your back with both knees bent.

Contract your core and lift your hips off the floor.                                                

Squeeze your buttocks at the top of that motion.

Slowly lower your hips back to the floor.

Repeat 10 times per set.

Do three sets, once or twice a day.

4. Side leg lifts

Lie on your side with your ankles stacked on top of one another. 

You can rest your head on a pillow or your arm.

Tighten your top thigh and lift your leg slowly, keeping your knee locked.

Slowly lower your leg to the original position. 

Repeat 10 times on both sides per set.

Do three sets, once or twice a day.

5. Clamshell

Lie on your side with your ankles stacked and your knees bent in an “L” shape.

Keeping your heels together, lift your top knee as if you were opening a clamshell.

Slowly lower your knee to the original position.

Repeat 10 times on both sides per set.

Do three sets, once or twice a day.  

6. Facedown leg raises

Lie flat on your stomach with your legs extended.

Tighten your thigh muscles and lift one leg off the floor, keeping your knee locked.

Slowly lower your leg to the original position.

Repeat 10 times on both sides per set.

Do three sets, once or twice a day.

7. Standing small range squat

Stand straight with your heels shoulder-width apart.

Hinge your hips and push your buttocks back, squatting as low as comfortable.

Slowly return to a standing position.

Repeat 10 times per set.

Do three sets, once or twice a day.