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Piriformis  Syndrome

Home > Pain Conditions > Piriformis Syndrome

About Piriformis Syndrome

The piriformis is a small muscle located in the buttock region which connects the lower spine to the upper surface of each femur (thighbone). Piriformis syndrome refers to the condition where the piriformis is affected, resulting in pain in the buttock region. Furthermore, the piriformis muscle can also irritate the nearby sciatic nerve, causing pain, numbness, and tingling along the back of the leg and into the foot similar to sciatic pain. It is not easy to differentiate piriformis syndrome from spinal nerve compression as both conditions present similarly.

What Causes Piriformis Syndrome?

Injuries or irritations to the piriformis muscles can cause muscle spasms. The piriformis muscle may also swell or tighten, which places pressure on the nearby nerve beneath it, causing pain.

Swelling, injury or muscle spasms may come from:

  • Fall or accidents landing on buttock
  • Over-exercising or performing repetitive motions like playing fencing, badminton, or soccer
  • Sitting for long periods of time
  • Lack of proper warm-up before an exercise
  • Lifting heavy objects

Symptoms Of Piriformis Syndrome

Lower body pain
The pain extends from the back to the thighs, calves, and legs, occasionally, it may also cause mild weakness of the leg. Athletes who overuse the gluteus maximus and other hip muscles are prone to damage and muscle spasm of the piriformis.
Inability to sit for a prolonged period
It may be difficult to maintain a sitting position for more than 20 minutes. Standing up may also cause pain but it improves with movements and stretching. Prolonged standing and walking may also trigger pain in the leg.
Tingling or numbness
Tingling or numbness may also be felt in the buttock and along the back of the leg, into the affected sole. Weakness may also present in the calf and the foot.

When Should I Seek Medical Attention?

You should seek medical help when:

  • Inability to sit for a prolonged period
  • Persistent pain at the buttock or hip
  • Pain in the buttocks aggravated by hip movements
  • The pain extends from the back to the thigh, into the calf and foot
  • Mild weakness in the affected leg

A Message About Buttock Pain

It is not easy to diagnose Piriformis Syndrome as its presentation is so similar to nerve compression secondary to prolapsed disc or bone spur causing spinal canal narrowing. Before one can label it as Piriformis muscular cause (pseudo-sciatica), we need to exclude nerve compression from an MRI spine. In the presence of nerve impingement, it is very difficult to diagnose the muscular pathology of Piriformis Syndrome.

While the presentation may be the same, the treatment of Sciatica and pseudo-sciatica is different. Sciatica’s treatment is directed at the spine, targeting nerve decompression and nerve desensitization through minimally invasive procedures or even surgical fusion of the spine. But in Piriformis Syndrome, the mainstay treatment is muscle relaxation through stretching, exercises and physiotherapy. In stubborn muscle conditions, Myospan injection of PRP or Botox may be needed to break the recurring muscle cramps

Diagnosing Piriformis Syndrome

Piriformis Syndrome has similar symptoms to and is often mistaken as sciatica. Both conditions interfere with the sciatic nerve, but Piriformis only affects the muscle. Here at Singapore Paincare, our team of experienced primary care doctors and pain specialists together with an orthopaedic doctor will evaluate your condition. An MRI or CT scan may also be needed to rule out other possible conditions like slipped disc or arthritis.

What Treatments Are Available for Piriformis Syndrome?

At Singapore Paincare, we strive to treat your pain with the least invasive option possible after accurately identifying the cause. Our approach to pain resolution focuses on the removal of pain generators via specialised injection and minimally invasive procedures. Combined with pharmacological treatments and cognitive and physical rehabilitative therapies, we help patients improve functions and prevent pain from recurring. 

Non-Surgical Treatments for Piriformis Syndrome

Physical Therapy
Stretching exercises are used to increase muscle extension, these exercises are moderated by our pain specialists to ensure that it is not excessive or counter-productive for the recovery of the muscle.
Coreflex Injection
Our Coreflex injection uses a mix of local anaesthetic, anti-inflammatory and muscle relaxant, which helps to break the pain cycle, reduce inflammation, and improve healing. Low-dose steroids may be added to improve the healing of muscle injury.

Myospan PRP (platelet-rich plasma) and/or Botox injection may be more beneficial in situations if the piriformis spasm recurs too quickly.

Surgical Treatment for Piriformis Syndrome

Stretching and injections form the cornerstone for Piriformis Syndrome treatment. In case all methods are exhausted, there is no role for surgery to treat the muscle tension spasm.

How Can I Prevent Piriformis Syndrome? 

Incorporating these strategies can help prevent piriformis syndrome:

  • Keeping a proper posture at all times especially when sitting and standing
  • Regular exercises
  • Doing a proper warm-up and stretching before any exercise or sports
  • Avoid sitting for long periods of time – take a break by standing, walking or stretching
  • Learn proper lifting techniques

Get Your Pain Resolved

Send your enquiries or consult our pain experts today.

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