Piriformis Syndrome: Diagnosis and Treatment
Pririformis syndrome is a fairly common condition with symptoms that feel similar to sciatic nerve pain. The piriformis is a small but essential muscle in the gluteal area that typically surrounds the sciatic nerve, a central nerve that runs from the spine, through the buttock, and down the leg. When the piriformis muscle irritates this nerve for any reason, the result can be a sensation of numbness, tingling or pain that radiates from the buttock area down the leg and up to the lower back. The muscles of the glutes may also become sore or tender to the touch. This irritation and tenderness can occur when the muscle spasms, or when it becomes inflamed or shortened, any of which can cause the muscle tissue to tighten around the nerve and generate unwelcome pressure.
Pririformis Syndrome: Diagnosis
The sensations that suggest piriformis syndrome are often very similar to those that result from sciatica, or the impinging and inflammation of the sciatic nerve around the spinal cord area. In fact, the sensations are so similar that doctors often diagnose piriformis syndrome by simply going down a list of other sciatic nerve problems and ruling them out. For example, a doctor will often subject a patient’s leg to a series of stretches and motions that rotate the leg at the hip and flex the adductor muscles. These movements are designed to stretch and activate the piriformis muscle and generate pressure against the nerve, and based on these movements and a general health history, the doctor can rule out herniated discs and spinal trauma (which can lead to sciatica), as well as other culprits like spinal stenosis and strained lumbar muscles.
If none of these other possibilities are likely, the chances of pririformis syndrome are high. Especially if the patient has been subjecting the muscle to any of the conditions below.
1. Overuse. Piriformis syndrome tends to be brought on by activities that stretch and strain the piriformis muscle beyond its natural limits. These activities typical involve intense motions performed while in a seated position, like heavy training for rowing or bicycling.
2. Underuse. Too much sitting with the hip flexors in a stretched position—the way most people sit while they work in an office—can increase the pressure of the piriformis muscle against the nerve. Sitting still for prolonged periods can train the hip flexors to become short and tight, and this can reduce activity in the glutes. Once the glutes become inactive, the supporting muscles around them, including the piriformis, are called upon to complete tasks they weren’t designed to do. The resulting strain can affect the nerve.
3. Falling injuries. Sometimes a fall can lead to trauma that interferes with the way a person walks. When we favor certain muscles and joints to avoid pain, a gait becomes unnatural, and supporting muscles like the piriformis can either atrophy or be subjected to strain and overuse.
4. Overprotination. When person walks with the foot rotated outward, the pirirformis muscle works extra hard to protect the knee from over-rotation. This can strain the muscle and lead to the numbness, tingling and other sensations associated with piriformis syndrome.
Piriformis Syndrome: Treatment and Recovery
If they symptoms are piriformis syndrome are present and the patient has been subjecting the muscle to any of the conditions described above, or any other repetitive stressful activity, like distance running, a doctor will probably recommend discontinuing these activities for the time being. If the symptoms may be caused by underuse or prolonged sitting, gentle stretching and an increase in activity may be enough to build strength in the muscle, lengthen the adductors, and relieve the pressure on the nerve.
In either case, a doctor or physical therapist will probably recommend a series of targeted, therapeutic stretches that increase adductor an abductor strength, lengthen and build up the muscles of the hip flexors, and restore balance and cooperation among all the supporting muscle groups in the glutes and hips.
In the meantime, RICE treatment can also help to significantly reduce the pain and numbness brought on piriformis syndrome. Patients can start by resting, (or at least altering) the weight they place on these muscles and the conditions they’re subjected to for prolonged periods. They can also apply ice pack to the area, or a bag of frozen vegetables wrapped in a towel to protect the skin from the cold. The ice pack should be kept in place for twenty minutes at a time, three or four times per day until symptoms recede.
Compression and elevation can also help, as with any muscle injury due to strain or overuse. Elevating the area and applying gentle continuous pressure can keep fluids from building up around the muscle and exacerbating pain and inflammation. These last two elements of the RICE treatment may be difficult in the area around the hips and glutes, but the principles can still apply.
Doctors may also recommend anti-inflammatory meds, muscle relaxants, or injectable anesthetics. In rare cases, surgery may be an option, but most cases of piriformis syndrome can be cleared up with treatments that are standard and non-invasive.
Piriformis Syndrome: Prevention
The best cure for piriformis syndrome, as with almost any injury related to muscle use, is prevention. Athletes who are vulnerable to this condition should avoid running on uneven surfaces, and should pay close attention to proper technique while working out, including foot placement during lunges and squats. Always warm up completely before engaging in activities that strain the glutes and hip flexors, and focus on proper posture while running, walking and sitting down.
Exercise on a regular basis and avoid sitting still all day if possible. If you aren’t sure where to begin and need some help setting up an exercise routine that fits your body and your schedule, reach out to the fitness experts at Kbands Training.com. Meanwhile, explore the site to learn more about developing an active lifestyle and using suspension and resistance training to meet your personal health and fitness goals.