Piriformis Syndrome

Piriformis is a band shape muscle extending at the depth of our hip. Piriformis syndrome is characterized with the symptoms of low back pain, hip and leg pain, numbing at the back of leg and towards the foot and tingling which result from the compression of sciatica nerve under the piriformis muscle.

Sitting increases pain for the individuals with piriformis syndrome. The pain is generally felt around low back and hip areas and increases when the patient walks or crosses his/her legs.

It may be confused with spinal disk hernia due to the symptoms of numbing and tingling at the back of leg and feet, difficulty in walking etc.

Piriformis syndrome has two types.

The first type syndrome results from structural shortness of the piriformis muscle. The problem is prevented through muscle stretching and extending exercises at the early period.

The second type syndrome arises from muscle spasm due to a trauma or reduction of local blood circulation. The treatment must be applied following the identification of the underlying reason. Muscle spasm may be related to problems in piriformis muscle, low back and spine or spinal muscles, incorrectly performed exercises, sudden and adverse movements, long term sitting (desk jobs, long term travels, cycling) or excessive use. Muscle spasm compresses the sciatica nerve under the muscle and leads to pain and sensual disorders.

HOW SHOULD PIRIFORMIS SYNDROME BE TREATED?

The patient must be recommended to have a rest and subjected to a spasm relaxing treatment for the piriformis muscle during the acute painful period. Long term standing or running may be restricted. If oedema exists, cold compress is applied and certain iliac muscle stretching exercises are advised.

Following the acute painful period, physiotherapy methods should be employed. Deep tissue laser applications (hyle therapy), ultrasound applications, iontophoresis which involves the penetration of physiologically active ions into the body through electricity current and phonophoresis which contains the penetration of medical agents into the body with the help of sound waves can be used to ensure tissue recovery, regulate intramuscular circulation and reduce local muscle spasm.

Manual therapy methods allow the maximization of circulation in the muscle leading to piriformis syndrome and around the joint and the reduction of tensions. The treatment program should also contain peripheral joint mobilization, relaxation of subcutaneous connective tissue, stretching and strengthening exercises. It is possible to regulate circulation by relaxing the spasm on piriformis muscle and completely get rid of low back, hip and leg pain by eliminating sciatica nerve compression.