Recovering from Neck Pain

Piriformis Syndrome And Its Treatment

by Janet Burns

Back pain can occur for a multitude of different reasons. In general, there are very few cases of low back pain that can be traced to a specific anatomical structure that has been affected. Instead, most cases of low back pain are simply referred to as "mechanical low back pain." However, there is one condition that can lead to back pain that is caused by an abnormality in a particular structure – piriformis syndrome.

Piriformis syndrome is a relatively common cause of back and leg pain, especially in those who spend a significant amount of time sitting. However, in order to understand why piriformis syndrome is more common in those who sit for extended periods of time, it may be helpful to understand the anatomy of the region, and the structures that are involved in piriformis syndrome.

The piriformis is a muscle that attaches from the pelvis to the thigh bone (femur), and it lies directly beneath the gluteus maximus muscle. The sciatic nerve is a large nerve that exits the low back, runs through, under, or over the piriformis muscle, and continues down the back of the thigh and into the lower leg and foot.

When the piriformis muscle is irritated in some manner, it can sometimes become inflamed. When inflammation occurs in the piriformis muscle, the sciatic nerve can sometimes become irritated. This is the underlying cause of piriformis syndrome.

What are the Signs and Symptoms of Piriformis Syndrome?

Although the signs and symptoms of piriformis syndrome can vary depending on the individual's acuity and their underlying anatomy, some of the most common signs and symptoms of the condition include:

  • Leg pain in the back of the thigh and into the knee
  • Numbness or tingling in the back of the thigh and into the knee
  • Pain that is worse when sitting
  • Tenderness over the outside aspect of the thigh
  • Pain when lifting the leg to the side of the body

Can Piriformis Syndrome Resolve Itself?

Piriformis syndrome is a condition that can resolve. However, without the appropriate treatment from a health care provider such as a chiropractor or physiotherapist, it can take a very long time to heal.

Physiotherapy treatment of the condition is centered around removing any excessive amount of stress from the piriformis muscle. This typically includes ice, or electrotherapeutic modalities that are intended to resolve spasm of the muscle. Additionally, physiotherapists may address any muscle imbalances in the hip or low back that may be contributing to the condition.

A relatively new treatment technique called trigger point dry needling can be effective at resolving spasms of the piriformis muscle. This procedure involves placing acupuncture needles into the muscle to elicit a chemical reaction that drives certain substances out of the muscle. When the procedure is effective, the spasm of the muscle is often resolved immediately.

Because of the relative ease with which the condition can be treated by well-trained health care providers, individuals with debilitating pain and discomfort should seek treatment from a physiotherapist or chiropractor as soon as the symptoms begin.