Piriformis Muscle, Symptoms and Piriformis Syndrome, Treatment

Piriformis syndrome is a low back condition that, frankly, is a pain in the butt. Literally, since the piriformis muscle sits just underneath the gluteus maximus, that spongy muscle that cushions us as we sit. The piriformis attaches the sacrum to the thigh bone. It is what we call an external rotator of the hip - it turns the thigh outward. Not that this is a movement we do often, but the piriformis has another essential function - it prevents the leg from collapsing inward as we walk.

The piriformis can actually become overworked. This is usually the case with people who have foot dysfunction, especially over-pronators. What happens is that over-pronators turn their feet and the legs inward excessively; this makes the piriformis muscle work that much harder. The combination of extra work plus dysfunctional stress leads to inflammation and spasm. But here’s the kicker: Sitting just beneath the piriformis is none other than the sciatic nerve. Piriformis spasms (becomes tighter) pinch the sciatic nerve, causing irritation and inflammation, and this can then lead to sciatica.

Piriformis syndrome presents itself in the following ways: Pain in the buttock or hip while sitting (it might even make sitting impossible), low back pain, pain while walking, running or bending forward. Depending on the location of the inflammation, the buttock pain might feel more like hip pain. And if the sciatic nerve does, in fact, get inflamed, then one might feel numbness and tingling into the butt, thigh or leg.

Treatment of piriformis syndrome includes icing the inflamed muscle and staying off the buttock, which means sitting with all the weight on the unaffected side or using a rolled up towel to prevent excessive pressure on the painful side. The pelvis will likely need adjusting, as people suffering from piriformis syndrome generally have a pelvic subluxation; lumbar spine and sacral subluxations are also common. Once the inflammation has been decreased, light stretching can be started. This will loosen up the tight muscle and take some pressure off the sciatic nerve. If the inflammation is very bad, therapeutic ultrasound can help big time. The final key to fixing a piriformis syndrome is to fit the patient to a custom-made orthotic. These insole devices will correct the foot dysfunction which will ultimately solve the problem long-term.

Piriformis syndrome is not fun - it's a real pain in the behind. It’ll keep you from doing even the most basic daily functions. If you are experiencing any of the symptoms I’ve described above, please visit your local sports chiropractor. There is no need to suffer when help is just phone call away.