Peak Physical Therapy

Piriformis syndrome is an uncommon neuromuscular disorder caused by the piriformis muscle compressing the sciatic nerve. The piriformis muscle is located in the buttocks near the top of the hip joint. It stabilizes the hip joint and lifts and rotates the thigh away from the body, enabling us to walk, shift weight from one foot to another, and keep our balance. It plays a part in almost every motion of the hips and legs. The sciatic nerve is a thick, long nerve that passes alongside or through the piriformis muscle, down the back of the leg, and branches off into smaller nerves in the feet. Spasm of the piriformis muscle can cause nerve compression.

Signs & Symptoms

Piriformis syndrome typically starts with tingling, pain, or numbness in the buttocks. The pain, which can be severe and extend down the length of the sciatic nerve, is due to the piriformis muscle compressing the sciatic nerve. This may occur while running, sitting for long periods of time, climbing stairs, or applying firm pressure directly over the piriformis muscle.

Diagnosis

Diagnosis is typically made by the patient’s report of symptoms and by physical exam, using a variety of movements to draw pain to the piriformis muscle. The sacroiliac joint, as well as the lumbar joints, need to be carefully evaluated to determine if they’re the cause of the stress on the Piriformis muscle, or if the pain is coming from the lumbar region. Small rotations in these joints can sometimes be the main cause.

Prevention

Prevention of piriformis syndrome is typically related to good form since it is usually caused by movement that repeatedly stresses the piriformis muscle. Warm up properly before performing physical activity. Avoid exercising on uneven surfaces and running on hills. Practice good posture while exercising, running, and walking. If you begin to feel pain during activity, stop and rest until it subsides.

Treatment

Try to avoid positions that trigger pain if it is caused by certain activities or sitting. A physical therapist can suggest exercises, soft tissue techniques such as foam rolling or a tennis ball, and stretches to help reduce sciatic nerve compression. Healthcare providers may recommend anti-inflammatory medications or muscle relaxants. Surgery may be recommended as a last resort.

How Can Physical Therapy Help?

Your physical therapist will choose the most appropriate treatment for you based on your presentation. This may include soft tissue mobilization, joint mobilizations, strengthening, laser therapy or ultrasound, positional modifications, exercise modifications, and stretches. You will also receive a home exercise program to ensure the most effective recovery.

Our South Shore Physical Therapy practice specializes in physical therapy including many specialty programs including return-to-sports, vestibular, pelvic health, post-concussion, aquatics, and more. Locations include Norwell, MA, Scituate, MA, Quincy, MA, Hanover, MA, Pembroke, MA, and Braintree, MA. Our specialized programs combined with state-of-the-art facilities allow us to meet the unique needs of our local patients and achieve the fastest results.