Piriformis syndrome

Piriformis syndrome is a result of impingement of the sciatic nerve by the piriformis muscle. Incorrect form or improper gait often leads to tightness and inflexibility in piriformis. The condition occurs more frequently in women than men (6:1). When piriformis becomes tight it puts pressure on the underlying nerve, causing pain similar to sciatica. The pain usually starts in the mid-gluteal region and radiates down the back of the thigh.

Cause of injury

Incorrect form or gait while walking or jogging. Weak gluteal muscles and/or tight adductor muscles.

Signs and symptoms

Pain along the sciatic nerve. Pain when climbing stairs or walking up an incline. Increased pain after prolonged sitting.

Complications if left unattended

Chronic pain will result if left untreated. The tight muscles could also become irritated causing stress on the tendons and points of attachment.

Immediate treatment

RICER. Anti-inflammatory medication. Then heat and massage to promote blood flow and healing.

Rehabilitation and prevention

During rehabilitation a gradual return to activity and continued stretching of the hip muscles is essential. Start with lower exercise intensity or duration. Identifying the factors that caused the problem is also important. Strengthening the gluteal muscles and increasing the flexibility of the adductors will help to alleviate some of the stress and prevent the piriformis from becoming tight. Maintaining  a good stretching regimen to keep the piriformis muscle flexible will help, while dealing with the other issues.

Long-term prognosis

Piriformis syndrome seldom results in long-term problems when treated properly. Rarely, a corticosteroid injection or other invasive method may be required to alleviate symptoms.

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