Piriformis syndrome is a neuromuscular disorder that can occur when the sciatic nerve is compressed or irritated by the piriformis muscle, which is located in the buttock region. When this happens, pain, numbness or tingling may be felt along the path of the sciatica nerve, traveling down the lower thigh and into the leg.
The Piriformis Muscle
The piriformis muscle is a small, band-like muscle located in the buttock, behind the gluteus maximus. Starting at the lower spine and connecting to the upper surface of each thighbone, the piriformis muscle plays an important role in lower body movement. It helps stabilize the hip joint and functions to assist in rotating the hip, as well as turning the leg and foot outward. This enables us to walk, maintain balance and shift weight from one foot to another. The piriformis muscle plays an integral role in sports and activities that involve lifting and rotation of the thighs. In short, this muscle is involved in just about every motion of the hips and legs.
What Causes Piriformis Syndrome?
It is not clear exactly what causes piriformis syndrome. There are certain problems that can arise in the piriformis muscle that are suspected to lead to the condition, including:
- Muscle spasm in the piriformis muscle, due to irritation in the muscle itself, or a complication of a nearby structure such as the sacroiliac joint or hip.
- Tightening of the piriformis muscle in response to spasm or injury.
- Swelling of the muscle as a result of injury or spasm.
- Bleeding in the area of the piriformis muscle.
Any of the above factors can adversely affect the piriformis muscle, leading to pain in the buttock and potentially affecting the adjacent sciatica nerve.
What are the Symptoms of Piriformis Syndrome?
Patients suffering from piriformis syndrome commonly refer to acute tenderness felt in the buttock region and sciatica-like pain that descends down the back of the thigh, calf and foot. Some patients describe experiencing a dull ache in the buttock, and increased pain after sitting for a long period of time or when walking up stairs. Most people with piriformis syndrome also experience reduced range of motion of the hip joint.
How is Piriformis Syndrome Treated?
Treatment for piriformis syndrome often includes a physical therapy program that incorporates stretches and exercises designed to alleviate sciatic nerve compression. This is usually complemented with other therapeutic measures to relieve symptoms such as rest, ice and heat application.
Depending on the severity of symptoms, physical therapy may also be supplemented with other treatments, including:
- Anti-inflammatory medications
- Steroid injections
- Muscle relaxants
In some cases, the patient may benefit from other therapies such as iontophoresis, where a mild electrical current is used to deliver medication to the muscle through the skin. Utilizing the paralytic properties of botulinum toxin (botox) has also proven to be an effective treatment method for piriformis syndrome. Botox injections help minimize pain by diminishing muscle tightness and subsequently alleviating sciatica nerve compression.
Schedule an Appointment at the Austin Diagnostic Pain Center
If you are experiencing pain, numbness or tingling sensations in the buttock, thigh, calf or foot, then piriformis syndrome could be to blame. Call (512) 981-7246 today to schedule an evaluation with an Austin pain specialist, Dr. Robert S. Marks, Dr. Sauman A. Rafii, or Dr. Ivan N. Chew.