Article by Alex Clarke
What is Piriformis Syndrome?
If you are experiencing hip, buttock, hamstring or sciatic pain then you may be suffering Piriformis Syndrome.
Piriformis syndrome is a disorder that occurs when your sciatic nerve is compressed and/or irritated by the piriformis muscle as it passes deeply through your buttock, resulting in pain. Sometimes the condition is called ‘pseudo sciatica’, as it is often confused with pain in the nerve resulting from a low back disc bulge.
Your diagnosis of piriformis syndrome should be made after a spinal nerve root compression (eg disc bulge) has been eliminated as a cause of your sciatica symptoms.
Where is your Piriformis Muscle?
Your piriformis muscle originates mostly from your sacrum (base of spine) to insert on the greater trochanter of the femur (thigh bone). In the standing position your piriformis muscle is a lateral hip rotator muscle, but it changes to a medial hip rotator in hip flexion due to its orientation. More information about the piriformis muscles can be found here: piriformis muscle.
What are the Symptoms of Piriformis Syndrome?
You may experience one or more of the following symptoms:
What Causes Piriformis Syndrome?
Piriformis syndrome is most commonly caused by your piriformis muscle overworking.
The main reasons that it overworks is due to:
How is Piriformis Syndrome Diagnosed?
In most cases , a clinical examination that excludes a lumbosacral spinal pathology as the cause of your symptoms will suspect piriformis syndrome.
Your physiotherapist will perform clinical tests to stretch the irritated piriformis or provoke sciatic nerve compression, such as the Freiberg, the Pace, and the FAIR (flexion, adduction, internal rotation) manoeuvers.
CT, MRI, ultrasound, and EMG are mostly useful in excluding conditions that could replicate piriformis syndrome. Magnetic resonance neurography can show the presence of irritation of the sciatic nerve but is rarely required.
What’s the Treatment for Piriformis Syndrome?
After a thorough assessment of your back, pelvis and hips, your physiotherapist will determine the cause of your pain.
Once your diagnosis is established, treatment could involve any of the following:
What’s Your Prognosis for Piriformis Syndrome?
Piriformis syndrome is effectively treated with physiotherapy in the vast majority of cases.
Short-term symptoms can be reversed within a few days. Longstanding symptoms may take a few weeks to address the biomechanical and muscle habits that have predisposed you to the injury. Only rarely will surgery be required.
For more advice about Piriformis Syndrome please ask your physiotherapist.
Common Treatment Options for Piriformis Syndrome
Helpful Products for Piriformis Syndrome
Related Injuries to Piriformis Syndrome
Hip Joint Pain
Lateral Hip Pain
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