Piriformis Syndrome Treatment & Therapy
Piriformis syndrome can cause severe lower back pain or sciatica. The radiating sciatic pain can emanate from the back all the way to the foot. The pain is worse while sitting, standing, and getting up from seated positions. It often fluctuates in intensity during the day, and can be very severe first thing in the morning. Piriformis syndrome can be debilitating and painful, but improvement can quickly take place with proper chiropractic and physiotherapy treatment.
What is Piriformis Syndrome?
Similar to sciatica, piriformis syndrome causes numbness, pain, and a tingling sensation in the back of your legs; however, the cause of the pain is different for each syndrome . In a true case of sciatica, the sciatic nerve is impinged by a protruding disc or spinal stenosis. However, in piriformis syndrome, the piriformis muscle spasms and irritates the sciatic nerve, causing the sciatic pain. (Click here for more information on differences between lumbar disc herniations vs piriformis syndrome.)
Your piriformis muscle is located deep in your buttock, behind your gluteus maximus. This muscle:
- Runs from the lower spine to the top of the femur
- Runs diagonally under the gluteus maximus
- Runs above the sciatic nerve
- Assists in hip rotation and outward foot rotation
- Contracts with prolonged standing, walking up stairs, and squatting.
What are the Symptoms of Piriformis Syndrome?
Lower back pain and radiating pain are common symptoms of the syndrome. Many people experience stiffness, dull or sharp pain, or stabbing pain. Some people describe a deep ache in their lower back and hip, while others feel more numbness, tingling, or feel as if their feet “fall asleep.” The sciatic pain travels down the back of the thigh, calf, and foot. The level of pain can fluctuate with activity and body position. The pain is often worse after sitting, climbing stairs,or a sitting for prolonged periods of time, but tends to decrease when lying on your back.
Orthopedic testing can differentiate between piriformis syndrome and other causes of lower back pain and sciatica; an MRI is not usually needed to diagnose piriformis syndrome. Leg and hip positions that stretch the piriformis muscle increase lower back and sciatic pain. Likewise, positions that relax the muscle decrease the back pain. These positions are different than lumbar disc herniations, which is why orthopedic testing can diagnose piriformis syndrome without needing an MRI. Lower back sprains, lumbar disc bulges, and stenosis can have the same symptoms, but act differently than piriformis syndrome under orthopedic tests.
How is Piriformis Syndrome Treated?
Piriformis syndrome is usually treated with progressive stretching, massage therapy, and physical therapy treatments. Electric therapy, heat and ice therapies, and other methods can quickly decrease the muscle spasms and reduce the pressure on the sciatic nerve.
With proper therapy and treatment, those who suffer from piriformis syndrome will see improvement in their condition quite quickly. Many of the exercises and stretches can be performed at home. Below are instructions for common stretches that can help alleviate muscle spasms in the hip. Stretches may aggravate other causes of sciatic pain, so they should be performed carefully, and only within a range of motion that is pain-free.
If you are suffering from sciatic pain, your routine should include hamstring stretches. There are many ways to stretch the hamstrings, including:
The chair stretch:
- Set out two chairs, facing each other
- Sitting on one, place one of your heels on the other chair
- Leaning forward, bend at the hips
- Keep bending until you feel a gentle pull at the back of your thigh
- Hold the stretch for the duration given to you by your Tempe chiropractor
The floor stretch:
- Keeping your legs straight, lie on your back
- Use a towel or tension band to pull one leg up
- Straighten the raised leg until you feel the stretch in the back of your thigh
- Hold the stretch for 10-20 seconds
Piriformis Muscle Stretching
There are two common ways to stretch the piriformis muscle at home. Start by lying on your back, with your knees bent, and feet both flat on the floor.
During the first stretch:
- Keeping your knee at 90 degrees, pull your right knee toward your chest
- Using your left hand, pull your knee toward your left shoulder
- Hold the stretch for 10-20 seconds
- Repeat for the left leg
During your second stretch:
- Place your right ankle over your left knee
- Pull your left thigh toward your chest until you feel the muscle stretch
- Hold this stretch for the duration given to you by your Tempe chiropractor
- Repeat for the other leg
More exercises and stretches can be found on the Conditions Treated Page.