Piriformis syndrome

Piriformis syndrome is one of the most common mechanical causes of nerve pain in the leg and sciatica. Piriformis syndrome involves dysfunction and pain due to tightness in the piriformis muscle deep inside the seat. Due to anatomy, there will always be some reduced movement in the pelvic joint on the same side as the tight piriformis muscle - it is therefore important that both joints (joint adjustment / joint mobilization) and muscles are treated in a holistic and good way.

There will always be a combination of factors when it comes to piriformis syndrome - among other things, you will also often feel that the gluteal muscles are more irritated and sore on the same side. It is sometimes claimed that this is a controversial diagnosis - but recent research has shown that the diagnosis is far from controversial. Feel free to contact us on Facebook if you have any questions or input.

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Anatomy: Where is the piriformis - and what does it do?

piriformis muscles - anatomy

The piriformis muscle sits deep inside the seat - and we have one on each side. It attaches to what we call the sacrum (which goes down to the coccyx and up to the lumbar spine) and attaches to the large triangular attachment at the hip. When we understand its anatomical landmarks, it is not difficult to understand how it can contribute to dysfunction in both the lower back and hip when it becomes too tight. The piriformis muscle, together with the gluteal muscles (especially the gluteus medius and minimus), is the muscle closest to the sciatic nerve - and which can cause local irritation against it. This causes what we call sciatica / false sciatica.

Cause: What causes piriformis syndrome?

There are several possible causes for this syndrome. The most common is overuse or overload over time which causes increased sensitivity, contraction (contraction) and irritation in the muscle fibers - which in turn leads to pain signals in the muscles themselves and surrounding areas. (1) Research has also shown that irritation of the nerve root S1 in the lower lumbar spine may contribute to higher malformations of the piriformis and make it contract. The latter is caused by the nerve signals of S1, among other things, being capable of sending electrical signals to piriformis. It is then necessary to treat the cause of irritation with holistic treatment (muscles and joints must be addressed for best effect) in combination with exercises and specific exercise.

Pain relief: How to cure piriformis syndrome?

There are a number of measures that can provide pain relief and pain relief for piriformis syndrome - both active and passive treatment. For natural reasons, as piriformis always has an anatomical involvement of impaired function in the pelvic joint and lower lumbar region, strong treatment is strongly recommended by a clinician who works with both joints and muscles (eg chiropractor) - this in combination with training and custom exercises of course. In the case of long-term piriformis syndrome, pressure wave treatment may also be relevant - which is performed by publicly authorized health personnel such as a manual therapist, physiotherapist and chiropractor.

For self-measures, regular stretching and specific exercises that strengthen the hip (including knitting exercises with exercise bands), seat and core. A clinician will provide you with customized exercises specific to you and your presentation. Self-measures such as self-massage (eg with trigger point balls) against tense muscles in the seat and hip can contribute to increased blood circulation and loosen up in tense and pain-sensitive muscle fibers.

Pain presentation: Symptoms of piriformis syndrome

Pain presentation will often cause pain in the pelvis, hip and can also cause tingling / radiation down deep in the seat, as well as further down towards the leg - depending on the degree of sciatic nerve irritation. A person with very clear piriformis syndrome will often rotate the foot on the same side outwards - as the piriformis muscle has less pressure on itself in this position.

The pain often overlaps with characteristic symptoms of sciatica / sciatica. The pain is often described as "deep", "toothache" and occasionally radiating pain down the leg.

Other common symptoms of piriformis syndrome is:

Impaired pelvic joint movement on the same side
Pressure relief over the PSIS of the pelvic joint on the same side
Occasional iling / radiation down the leg
A sense of toothache deep inside the seat
Can give a feeling of tail pain
Pressure relief in nearby muscles in the seat and against the hip
Abnormal movement in the affected area due to pain and irritation

It will often overlap with other diagnoses such as lumbago and impaired pelvic movement - for natural reasons due to incorrect loading and compensation. The symptoms of piriformis syndrome can vary in both intensity and duration. Some cases are mild and go away on their own - while others, more serious cases, need treatment by professional clinicians who work with muscles and joints on a daily basis.

Epidemiology: Who gets piriformis syndrome? Who is most affected?

Piriformis syndrome affects women twice as often as men - this has to do with the fact that pelvic position and anatomy are different in women compared to men. Those between the ages of 30 and 40 are most often affected by this condition.

Exercises and stretching: What exercises can help against piriformis syndrome?

Exercises and training to relieve piriformis syndrome will focus on two main goals:

Contribute to more flexibility and mobility in seat muscles and piriformis.
Strengthen hip, core and seat muscles to relieve the exposed areas.

Strengthening hip stability - as shown in these exercises - is very important. Often, reduced strength in the hip is a contributing factor to the development of piriformis syndrome - so naturally, strengthening the hip and other stability muscles will be extremely important. For best results, exercise and stretching should be combined with professional treatment by clinicians who are officially authorized muscle and joint experts (eg chiropractor).

Try these: - How To Get Stronger Hips

And these: 4 Exercises against Piriformis Syndrome

Treatment of piriformis syndrome

physiotherapy

Treatment of piriformis syndrome will focus on restoring normal joint movement, working on muscle tension (myalgia) and home exercises in the form of a training program aimed at this type of problem.

Some treatment methods may be:

Acupuncture and needle treatment: Treatment with needles can help with muscle pain and provoke increased healing in nearby tissues. We are talking about intramuscular acupuncture - not "Chinese acupuncture".
Physical treatment: This includes treatment measures such as TENS, massage, heat treatment, cold treatment and stretching techniques.
Medical treatment: Painkillers can provide pain relief, but do not change the root cause of the problem.
Muscle Knut Treatment: Muscular treatment can reduce muscle tension and muscle pain in the back, hip and buttocks.
Joint Treatment: An expert in muscles and joints (eg chiropractor or manual therapist) will work with both muscles and joints to give you functional improvement and symptom relief. This treatment will be adapted to each individual patient based on a thorough examination, which also takes into account the patient's overall health situation. The treatment will most likely consist of joint corrections, muscle work, ergonomic / posture counseling and other forms of treatment that are appropriate for the individual patient. In piriformis syndrome, special emphasis is placed on treatment of the pelvic joints and lumbar spine - as this has a direct effect on the piriformis muscle and vice versa.
Trigger point massage / muscle knot therapy: Work to work on tension and tension in muscle and tendon joints can provide pain relief and functional improvement. Here you can also achieve a lot even with a set of trigger point balls of different sizes.
Yoga and meditationYoga, mindfulness, breathing techniques and meditation can help lower the level of mental stress in the body. A good measure for those who stress too much in everyday life.

Self-help: What can I do even for muscle and joint pain?

Piriformis syndrome causes increased muscle tension in the back, seat and pelvis. We always recommend that self-treatment is one of the main measures in the fight against pain - with regular self-massage (eg with trigger point ball) and stretching can help prevent pain in the muscles and joints.

1. General exercise, specific exercise, stretching and activity are recommended, but stay within the pain limit. Two walks a day of 20-40 minutes make good for the whole body and sore muscles.

2. Trigger point / massage balls we strongly recommend - they come in different sizes so you can hit well even on all parts of the body. There is no better self help than this! We recommend the following (click the image below) - which is a complete set of 5 trigger point / massage balls in different sizes:

3. Training: Specific training with training tricks of various opponents (such as this complete set of 6 knits of different resistance) can help you train strength and function. Knit training often involves more specific training, which in turn can lead to more effective injury prevention and pain reduction.

4. Pain Relief - Cooling: Biofreeze is a natural product that can relieve pain by cooling the area gently. Cooling is especially recommended when the pain is very severe. When they have calmed down then heat treatment is recommended - it is therefore advisable to have both cooling and heating available.

5. Pain Relief - Heating: Warming up tight muscles can increase blood circulation and reduce pain. We recommend the following reusable hot / cold gasket (click here to read more about it) - which can be used both for cooling (can be frozen) and for heating (can be heated in the microwave).

6. Prevention and healing: Compression noise like that like this can increase blood circulation to the affected area, thereby speeding up the natural healing of injured or worn muscles and tendons.

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