Piriformis SyndromeWhen people are diagnosed with piriformis syndrome, it is thought that the piriformis tendon may be tethering the sciatic nerve, and causing an irritation to the nerve. While it has not be proven, the theory supported by many physicians is that when the piriformis muscle and its tendon are too tight, the sciatic nerve is pinched. This may decrease the blood flow to the nerve and irritate the nerve because of pressure.
Common signs and symptoms experienced by people who have been diagnosed with piriformis syndrome include:
- Pain behind the hip in the buttocks
- Electric shock pains traveling down the back of the lower extremity
- Numbness in the lower extremity
- Tenderness with pressure on the piriformis muscle (often causing pain with sitting on hard chairs)
Sometimes referred to as "deep buttock pain," other causes of this type of pain include spine problems (including herniated discs and spinal stenosis), sciatica, and hip bursitis. The diagnosis of piriformis syndrome is often given when all of these diagnoses are eliminated as possible causes of pain.
Treatment of Piriformis SyndromeUnfortunately, the treatment of piriformis syndrome is quite general, and often this is a difficult problem to recover from. Some treatment suggestions are:
- Rest: Avoid the activities that cause symptoms for at least a few weeks
- Physical Therapy: Emphasis on stretching and strengthening the hip rotator muscles
- Anti-Inflammatory Medication: To decrease inflammation around the tendon
- Deep Massage: Advocated by some physicians
- Cortisone Injections: Injections in the area of the piriformis tendon may decrease inflammation and swelling
In rare circumstances, surgery can be performed to loosen the piriformis tendon, called a piriformis release. This surgical procedure should only be considered when simple treatments have been tried for a minimum of 6 months, and when other common causes of pain have been evaluated. While the surgery is straightforward, it is invasive, and recovery takes several months.