Piriformis Syndrome

 

Piriformis syndrome is a condition where the piriformis muscle causes pain in the gluteal region as well as possibly down the leg.

 

In the severe form, the piriformis muscle can cause intermittent sciatica.  This can then cause pain, numbness, and sometimes weakness that shoots from the low back or buttock, down the leg.  Sciatica is a symptom, not a disease itself.

 

What is the piriformis muscle and sciatic nerve?

The piriformis muscle lies in the buttock region.  It goes from your sacrum (tailbone) to the upper femur (thigh bone).  Pressure is put on this muscle when sitting.  It is used considerably while walking.

 

The sciatic nerve is a large collection/bundle of numerous individual nerves that originate from the low back.  These smaller nerves exit the spine at each level (one on each side), then come together in the buttock region.  This sciatic nerve can pierce right through the piriformis muscle in some people.

 

What causes piriformis syndrome with intermittent sciatica? 

The piriformis muscle can become tight or spasmed.  When this happens, it can become painful itself, or, in those people born with the sciatic nerve going through piriformis muscle, the nerve is then pinched and irritated.  

 

Symptoms of piriformis sciatica (*will likely only feel some of these symptoms)

• Low back pain

• Buttock pain

• Leg pain

• Numbness and/or tingling in the leg/foot

• Weakness

 

Diagnostic workup of piriformis syndrome with sciatica

If the piriformis muscle is thought to be the source of the pinching, stretching of the piriformis muscle in the clinic will be done.  Stretching the painful side causes much more pain than stretching the pain-free side.

 

Treatment options for sciatica pain

Anti-inflammatories medications, physical therapy (particularly stretching the piriformis muscle), pain injections (into the muscle to help relax it) and as a last resort, surgery.