Piriformis syndrome is a condition in which the piriformis muscle causes pain in the buttocks. The piriformis is a muscle located deep inside the buttock area and toward the top of the hip joint. It is used to lift and rotate the thighs and in any motion by the hips and legs; such as, walking, staying balanced, running, lifting, sports activity, shifting weight from one leg to the other, etc.
The sciatic nerve is also located deep inside the buttock area. The sciatic nerve runs alongside the piriformis muscle, and after branching off into smaller nerves, it ends at the feet. The piriformis muscle can become irritated or spasm which causes pressure on the sciatic nerve. This results in pain that launches at the buttocks, sometimes extends down the back of one or both legs, and occasionally enters the feet area. Other than pain, tingling or numbness may also be felt in the affected area.
Although the main symptom of piriformis syndrome is pain, tingling, and numbness in the buttocks, a reduced range of motion in the hip or upper leg area may also be experienced. Women tend to be more at risk of developing piriformis syndrome than men. The pain felt from piriformis syndrome can be achy, bothersome, and frustrating; however, in more severe cases, it can be excruciating and debilitating.
There are many causes of piriformis syndrome including walking, running, overusing the muscle, sports-related injuries, exercising excessively, lifting, stair climbing, remaining seated for prolonged periods of time, poor posturing, and any repetitive activity involving the use of the legs. Trauma such as falls, vehicle accidents, sudden jolts, direct hits to the area, etc., can also cause piriformis syndrome. The muscle can also just spasm without a known cause.
No definitive test for piriformis syndrome exists; physicians begin the diagnostic process by ruling out other causes of this pain. A doctor will also perform a physical exam, including a range-of-movement test, and possibly order imaging test such as an ultrasound. The first treatment is rest and avoiding activities that make piriformis syndrome worse. Many times, physical therapy is also recommended in order to learn proper stretching techniques. Furthermore, deep massages performed by a licensed professional can offer some relief as well as ice and heat therapy. Anti-inflammatory medications such as ibuprofen and naproxen may help with the inflammation. Muscle relaxants may be prescribed to control muscle spasms. In severe cases of piriformis syndrome, a corticosteroid injection may be used, and as a last resort, surgery may be performed.