The piriformis muscle is part of the gluteal region responsible for lateral rotation of the extended thigh and abduction of a flexed thigh. In piriformis syndrome the sciatic nerve is irritated and/or compressed by this muscle leading to pain, numbness and tingling into the nerve distribution which includes the buttock and continues to run down the backs of the thigh and lower leg as well. This diagnosis does not include distribution pain originating from spinal nerves or spinal discs, however.
Causes for this painful and sometimes debilitating condition are varying. It can be caused by a piriformis muscle that has gone into spasm from overuse and hypertrophy/tightness in athletes such as runners and cyclists. It can also be caused by overactive and taught hip-flexors which lead to reduced activity of the gluteal muscles, referred to as reciprocal inhibition, common in those who sit for long periods of time. Inhibition of the gluteals will lead to the synergistic (helping) muscles “picking up the slack” and begin compensating for the weakened gluteal muscles. Among the compensating synergistic muscles is the piriformis muscle.
Another common cause that is often overlooked is over-pronation of the foot on the same side as irritation. Over-pronation can lead to many different conditions (to be discussed in an upcoming article) including piriformis syndrome. Over-pronation causes excessive medial knee rotation which in turn results in the piriformis muscle being over-activated to counter and compensate for this unnatural motion. This leads to overuse and tightness of the muscle which can produce the painful syndrome.
In order to reintroduce balance to the muscle system there are several things that both patients and doctors/therapists can do:
- Strengthening weak and stretching tight muscles
- Retrain specific movement patterns
- Non-Steroidal Anti-Inflammatories (NSAIDs)/muscle relaxants
- Massage and myofascial release techniques
- Core strengthening and stabilizing
- Foot orthotics
- Ice and/or heat (depending on duration of the condition)
There are other more serious conditions which may begin with and/or include similar symptoms to that of piriformis syndrome. If you are experiencing any symptoms be sure contact your health care provider for an assessment and proper plan of management.
Posted Dr. Rashaad Nauth-Ali on April 2nd, 2012 [Activity, Chiropractic, Exercise, Fitness, Golf, Health and Wellness, Injury, Pain, Sports, Uncategorized]