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Piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle also can irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (similar to sciatic pain).
The piriformis muscle:
- Starts at the lower spine and connects to the upper surface of each femur (thighbone)
- Functions to assist in rotating the hip and turning the leg and foot outward
- Runs diagonally, with the sciatic nerve running vertically directly beneath it (although in some people the nerve can run through the muscle)
Symptoms
Most patients describe symptoms of acute tenderness in the buttock and sciatica-like pain down the back of the thigh, calf and foot. Typical piriformis syndrome symptoms may include:
- A dull ache in the buttock
- Pain down the back of the thigh, calf and foot (sciatica)
- Pain when walking up stairs or inclines
- Increased pain after prolonged sitting
- Reduced range of motion of the hip joint
These symptoms often become worse after prolonged sitting, walking or running, and may feel better after lying down on the back.
Treatment
Almost every treatment for piriformis syndrome will include a focus on carefully and progressively stretching the muscle.
Other treatment modalities include:
- Physical therapy: Range-of-motion exercises, deep massage, or Extracorporeal Shockwave Therapy
- Trigger Point Dry Needling
- Ice packs and ice massage
- Heat therapy
- Medications: anti-inflammatory medications (such as ibuprofen or naproxen) to reduce the swelling that is usually contributing to the patient’s pain
- Injections: corticosteroid plus a local anaesthetic; Botox
- TENS unit