What is Piriformis Syndrome?
Piriformis Syndrome is a condition whereby irritation of the piriformis muscle causes buttock pain along with pain in the back of the leg. Depending on the severity, the leg pain can be limited to the upper (hamstring) porton of the leg, but it can extend down into the calf or even as far as the foot. Because of these leg symptoms, piriformis syndromes are frequently mistaken for sciatica.
The piriformis is a pear-shaped muscle, located deep to the gluteal muscles on the side of the buttocks, which serves to rotate the hip outward. Like other muscles, it can be strained and overused with activity, but because of its proximity to the sacroiliac joint, it is also commonly involved when there is irritation in the sacroiliac joint.
Common Causes of Piriformis Syndrome:
Activities that cause repetitive outward rotation of the hip, especially when against resistance, can fatique and strain the piriformis muscle. Skating, where you push off with the inside edge of the skate blade is a classic example of this type of movement, however, walking and running, especially in patients who have subtle abnormal foot mechanics, can also lead to piriformis irritation.
Another commonly seen cause of piriformis syndrome is in relation to sacroiliac joint irritation. In general, when joints become irritated, the muscles that cross those joints will guard with protective spasm. Since the piriformis muscle crosses just under the sacroiliac joint, irritation to this joint causes the piriformis to tighten. Since muscle is made to contract and relax, constant contraction such as this causes the build up of lactic acid and other by products of muscle contraction. This build up will first irritate, then actually damage muscle cells ultimately leading to what is clinically referred to as a myofascial trigger point, which in the case of the piriformis, causes referred pain in the leg.
Common Symptoms of Piriformis Syndrome:
Piriformis Syndrome typically causes pain in the buttock and upper portion of the back of the leg, but this leg pain can also involve the calf and the foot. It is usually described as deep, dull or achy, with at times the pain shooting into the leg with certain movements. Prolonged sitting often aggravates the condition.
Treatment of Piriformis Syndrome:
Treatment of Piriformis Syndrome is directed at reducing inflammation and spasm in the muscle and, if present, breaking up any trigger points that are present. The biomechanics of the sacroiliac and lumbar facet joints are also assessed to ensure that they are functioning properly, and thereby not contributing to the condition. A gait analysis will reveal any foot mechanic factors that need to be addressed both to prevent on-going aggravation of the current condition, and also to prevent a future re-occurrence of piriformis syndrome. Finally, a simple home exercise program is also incorporated to prevent re-occurrences and to help maximize muscle elasticity. As always, our goal is to offer our patients quick and cost-effective relief of their pain by providing the most innovative, scientifically proven combination of treatments available for their condition.
If you have questions regarding your specific condition or treatment, please do not hesitate to contact us at The Chiropractic & Sports Injuries Centre of Georgetown today!
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