?What Is Piriformis Syndrome?
It sounds like a strange word. The Piriformis is a muscle that goes from the lower part of the back to the hip and turns the hip outwards as a stabiliser of the pelvis and hip when you walk and provides a lot of stability to the back.
The reason that piriformis syndrome comes up a lot is that when it is malfunctioning, it can be a source of a lot of pain.
The reason is that the sciatic nerve runs through the piriformis muscle and goes down the leg. So often people get diagnosed with piriformis syndrome as a cause of sciatic pain.
This is often misdiagnosed as the sciatic nerve can often be trapped farther up the spine either by a disc or a subluxation of the spine itself. So it’s important to get the correct diagnosis.
You rarely see a piriformis syndrome in isolation and is usually a multifactorial problem.
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What does piriformis syndrome feel like?
It feels the same as sciatica. Pins and needles, numbness, tingling going down the back or the side of the leg. They can go from the lower back or the buttock and all the way down the hamstring, the back of the leg, into the foot and can cause problems with the toes as well, numbness in the toes.
This can be extremely painful and debilitating and can often keep people off work or immobile for weeks, sometimes months at a time, without a true prognosis.
How is it different to sciatica?
Sciatica is usually where there is an entrapment of the sciatic nerve by the disc or further up in the spine from a disc prolapse, spinal subluxation or misalignment. This can cause pressure on the nerve, thus causing the sciatic pain on the leg. They both present in the same way.
There are a number of tests to determine between the two and we use X-rays to find out where the sciatic nerve could possibly be entrapped to examine the holes where the nerves run through at the base of the spine. Plus a lot of examination techniques during our initial consultation process to find out if it is a true piriformis syndrome.
A common misconception is that if piriformis gets very tight and that’s what causes the sciatic nerve to tense up. Well, very often it’s where the piriformis is underactive and when it relaxes, it flops down onto the sciatic nerve causing pain and when the leg isn’t turned out, it’s activated, it stops the pain in many cases.
What causes the piriformis to cause the problem?
Because we sit for too long and are often inactive. We don’t use our glutes and piriformis to stabilise our hips and pelvis. They then get lazy and this can cause long-term problems with the piriformis, thus causing the problems down the leg.
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How to treat piriformis syndrome?
One of the best ways is with soft tissue massage or sports massage. Stripping the muscle out, activating it and trying to reduce the adhesions in order for it to function properly again and take the pressure off the nerve.
This is often quite tender but can produce amazing relief after the session. If you want to learn more about what we do with piriformis syndrome here with our deep tissue massage therapist, then please inquire here.
Things you can do at home are to apply ice on the area in 10-minute intervals on and off. Also using a tennis ball or a lacrosse ball on a chair and putting it on the piriformis and then putting your weight through that will break down some of the adhesions through that piriformis.
Another way is to use the stretch here, to actually stretch the piriformis out and recorrect its length and that can often help with the symptoms also. If you would like to know more about this, then watch this video here
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