Piriformis Syndrome

By Genesis Villanueva

Piriformis Syndrome

Piriformis syndrome is a neuromuscular disorder that is caused when the piriformis muscle compresses the sciatic nerve. The piriformis is a broad muscle that attaches from the lateral pelvic surface of the sacrum to the greater trochanter of the hip. The hip joint is involved in abduction and external rotation. Furthermore, the piriformis provides stability to the hip while walking.

The sciatic nerve is a thick nerve that is comprised of lumbosacral spinal nerves levels L4-S3, which runs down through the posterior aspect of the upper thigh. It is responsible for carrying signals to the muscles of the posterior thigh and lower leg. It also carries sensory information from the posterior thigh to the plantar aspect of the foot. The sciatic nerve starts from the lower back and passes through the sciatic notch of the pelvis, and under the piriformis muscle down to the back of the legs. There is a small population in which the sciatic nerve. This population actually passes through the piriformis muscle through the back of the thigh.


Causes of this condition remain unclear, but it is often surmised that muscle spasms or tightness of the piriformis will result in compression of the sciatic nerve. In some cases, the direct trauma of the region of the sciatic nerve and piriformis can cause scar tissue and bleeding where the sciatic nerve passes. Scar tissue is less pliable than muscle fibers, and can cause irritation to the sciatic nerve.

Piriformis Syndrome

Image of the Hip Anatomy


Diagnosis and Treatment

Symptoms of piriformis syndrome often include pain beginning at the buttocks and radiating to the back of the thigh. Numbness and tingling can be present in the lower leg to the foot. Also, general weakness in the lower leg may be present as well. Diagnosis of Piriformis Syndrome is often made with a comprehensive subjective history and physical examination. An MRI test may also be utilized to help with diagnosis.

Treatment of this condition often includes a prescription of anti-inflammatory medication to reduce the inflammation of the sciatic nerve, and course of Physical Therapy. Physical Therapy will typically prescribe exercises aimed at addressing piriformis muscle length, and pain reduction. A physician may suggest injections if the problem is not improved with Physical Therapy. If the problem is not improved by physical therapy, a physician may suggest injections. Surgical intervention is very rare for this condition.

By: Genesis Villanueva PT

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