How to Diagnose Piriformis Syndrome

The sciatic nerve runs from the spinal chord, through the gluteus maximus (buttock) and down the back of each leg. The piriformis is a muscle that forms part of the buttock. It connects the femur to the pelvis The sciatic nerve runs underneath the piriformis. When the piriformis becomes tight, swells or goes into spasms, it puts pressure on the sciatic nerve. The pain radiates down the back of the thigh, and can go as far as your foot. Causes include prolonged sitting and trauma. Climbing stairs, running, walking and sitting can make it worse. Specialized surgery usually cures it.

Instructions

• 1

  Consider the possibility of piriformis syndrome if you feel pain, numbness or tingling in the buttocks muscle or in the upper leg. Especially consider it if there has been minor trauma to the buttocks region. Doctors tend to diagnose such pain as caused by a spinal disk problem. This is usually the cause, but not always.

• 2

  Cross piriformis syndrome off the list of possibilities if the pain goes up to your lower back. Piriformis syndrome doesn't go that far up.

• 3

  Mention piriforis syndrome to your doctor. Sciatica is a common diagnosis, but piriformis syndrome is not. If the doctor is unaware of piriformis syndrome, you could end up getting a back surgery that does nothing for your problem.

• 4

  Request magnetic resonance neurography, which is a highly accurate method at diagnosing piriformis syndrome. Regular MRI scans can't show nerve tissue.

• 5

  Resort to MRI or CT scans for the purpose of a differential diagnosis if the equipment isn't available for an MR neurography. It determines if there is a tumor or cyst pressing on the sciatic nerve, or if a spinal hernia is the source. Such scans can also help recognize asymmetry in the piriformis muscle, which is a hallmark of piriformis syndrome.

• 6

  Consider piriformis syndrome if you had lower back surgery but the pain in your buttocks and leg(s) didn't diminish. Doctors are sometimes reluctant to discuss the situation when a surgery has failed, so you may have to take the initiative in proposing it.