The piriformis muscle is one of six muscles in the gluteal region that runs from the lower spine to the top of the thigh bone/greater trochanter. It assists in rotating the hips and turning the leg and foot outward. Piriformis syndrome occurs when the piriformis muscle contracts and compresses the sciatic nerve, causing pain that is typically felt on one side of the body, and runs/radiates from the lower back and down the leg.
Piriformis syndrome can develop from common everyday activities, including sitting for long periods of time, walking or running, climbing stairs or inclines, as well as following traumatic events such as a fall or car accident. Due to injury or spasms, the piriformis muscle may contract or swell, placing pressure on the sciatic nerve. Symptoms include sciatica pain, increased pain after sitting for a long period of time, decreased mobility/range of motion, and dull pain in the gluteal region. Relief is typically felt when a person lays in the supine position (on the back).
There is no simple test to diagnose piriformis syndrome. The condition is generally diagnosed based upon the patient’s symptoms and a physical exam is given to rule out other potential causes of pain. The physical examination will determine if pain occurs with movement, as well as if the pain is localized in the lower back or radiates down the leg(s). X-rays and other imaging tests are unable to determine if the nerve is being compressed/damaged by the piriformis.
Treatment options include several weeks of rest, physical therapy, massage therapy, stretching, anti-inflammatory medications, the use of cold and hot compresses, and injections. Surgery may be necessary to relieve pressure on the sciatic nerve.