What is it?
The piriformis is a muscle which attaches from the lateral border of the sacrum to the lateral aspect of the greater trochanter (hip). Its purpose is to help externally rotate and extend the hip joint. Piriformis syndrome occurs when this muscle irritates the sciatic nerve, which runs directly underneath or through the piriformis muscle. This condition can result in gluteal pain and radiating down the leg.
What causes it?
There are a number of causes for piriformis syndrome but the most common are:
1. Tension or spasm within the piriformis muscle itself, usually from excessive sitting. Individuals with jobs which require a lot of sitting and/or driving can cause shortening and tightening of the piriformis muscle. This will physically irritate the nerve.
2. Chronic hypertonicity of the piriformis muscle from gait abnormalities, especially overpronation of the foot. If you notice your shoes are wearing unevenly in the heel, you may be over pronating when you walk. Our bodies compensate for this abnormality by turning the toe outward during the swing phase of gait and as a result we are externally rotating the hip with each and every step. Over time this will cause tightening of the piriformis and lead to physical irritation of the sciatic nerve, similar to the discussion above.
3. Chemical irritation of the sciatic nerve can occur when inflammatory byproducts are produced in the tissues surrounding the nerve. This is most associated with trauma and can even occur in addition to the conditions noted above.
How is it treated?
The short-term solution is to have the piriformis stretched and worked on by your chiropractor or massage therapist. Your chiropractor can also adjust the joints of the pelvis and the hip which will help take tension off the sciatic nerve. Your practitioner can also show you at-home stretches that can be done in order to relieve symptoms while at home.
The long-term solution is to determine what your aggravating factors are for piriformis syndrome. Are you sitting too much? Are you over-pronating while walking? If this is the case, then more long-term therapy will be needed or the condition will continue to return. Orthotics and maintenance programs can be designed for you that will help to keep you feeling and functioning your best.
If this is something you have struggled with, book a free consultation with us or talk to your health care provider about your treatment options.