Piriformis Syndrome
Piriformis syndrome comes from a spastic piriformis muscle that can compress or irritate the sciatic nerve. It is estimated that piriformis syndrome contributes to up to a third of all back pain. (1,2) The spasticity of the piriformis is associated with lower cross syndrome and dysfunctional movement patterns.
Patients with piriformis syndrome have pain, or numbness or tingling starting in the gluteal region and traveling the course of the sciatic nerve into the leg. Holding any one position longer than 15-20 minutes often makes the pain worse. Any form of rotating the hip inward is typically painful.
Management for piriformis syndrome includes stretching and manual release of the piriformis along with correcting the underlying dysfunction. Rehabilitation exercises will often be aimed at central stability, hip extension and hip range of motion. Some patients who have a corresponding loss of a longitudinal arch of the foot can benefit from orthotics.
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Papadopoulos EC, Khan SN. Piriformis syndrome and low back pain: a new classification and review of the literature. The Orthopedic Clinics of North America. 2004 Jan;35(1):65-71.
Pace JB, Nagle D. Piriformis syndrome. Western Journal of Medicine. 1976 Jun;124(6):435.