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
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
Inability to sit for a prolonged period
Tingling or numbness
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
Coreflex Injection
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
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