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What is Piriformis Syndrome?

Form of sciatica due to an abnormal condition of the piriformis muscle
Disability from piriformis syndrome is very long lasting and severe

Incidence

affects females > males, 6:1

​Anatomy

  • 90% sciatic nerve passes beneath piriformis
  • 10% muscle is divided and nerve is divided within the muscle

Theories

  • piriformis contraction may squeeze the sciatic nerve
  • inflammation of piriformis causing compression on the sciatic nerve
  • gluteal muscles (buttock) weakness causing overactivity of piriformis
  • arthritic spurs cause shortening of the sciatic nerve.
  • The sciatic nerve is impinged by contraction of piriformis, pulling on the nerve roots causing hypersensitivity and intermittent claudication of the sciatic nerve
  • hamstrings shortness/ tight ligaments causing piriformis tightness

Symptoms

  • painful/ difficult sexual intercourse in female patients
  • limp with dragging of the affected side
  • low back pain with/ without sciatic referral
  • pain in the buttock and down the sciatic nerve distribution
  • pain is increased by lifting, sitting
  • pain is decreased by traction of the affected leg
  • pain is always on one side
  • pins and needles and/ or weakness of the affected leg

Management – Physiotherapy

  • traction to the lower limp in hip flexion / abduction
  • mobs to SIJ
  • massage and trigger point releases
  • ultrasound to piriformis
  • home stretches flexion + adduction + internal rotation
  • core muscle strengthening exercise program
  • avoid prolonged sitting, walking or running

Disclaimer: The information is for informative purposes and not to replace proper treatment. For more information or to book an appointment please contact Sydney Physiotherapy and Sports Injury Clinic

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