Piriformis Syndrome
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 Physios and Allied Health Services