December Newsletter - Piriformis Syndrome

What is Piriformis Syndrome?

If you are experiencing hip, buttock, hamstring, or sciatic pain then you may be suffering from Piriformis Syndrome. It occurs when your sciatic nerve is compressed and/or irritated by the piriformis muscle. Your sciatic nerve can pass;

  • above your buttock muscle (33% of people), or
  • through your buttock muscle (33% of people), or
  • below your buttock muscle (33% of people).

If you happen to be someone where the nerve passes through the buttock muscle, it is more likely to become irritated and cause you pain.

What are the Symptoms of Piriformis Syndrome?

Pain is usually felt in one buttock, but you may experience a radiation of pain down the back of the leg (sciatica). Pain is aggravated by hip activity, eg walking, or prolonged sitting. Most people will sit lopsided to avoid pain and pressure on the area that is sore, i.e. with your sore buttock tilted up. Some people will walk with the foot turned out due to shortening of the piriformis muscle.

What Causes Piriformis Syndrome?

It is most commonly caused by your piriformis muscle overworking, usually due to:

  • Protection or dysfunction of the adjacent SIJ (tailbone) or hip joints 
  • Weakness of your deep hip stabilising muscles
  • Over pronating (flat) feet

What’s the Treatment for Piriformis Syndrome?

After a thorough assessment of your back, pelvis and hips, your physio will determine the cause of your pain and treatment can include:

  • Joint mobilisation to restore normal joint mobility and function
  • Massage or electrotherapy to help decrease pain and spasm in your piriformis and increase blood flow plus soft tissue extensibility
  • Stretching program for muscle length and flexibility
  • Dry needling (acupuncture) to reduce muscle tightness
  • Hip/bottom strengthening exercises to stabilise your hip, pelvis and spine
  • Foot orthotics and/or exercises to help restore foot and leg alignment

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