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Treatment of Piriformis Syndrome

The piriformis is a muscle in the gluteal component of the lower limb. Piriformis syndrome is a neuromuscular disorder, occurring when the sciatic nerve---a nerve running along the piriformis muscle---is compressed or irritated by the piriformis muscle. This results in pain, numbness and tingling in the buttocks and along the border of the sciatic nerve. Luckily, several treatment options exist for patients who suffer from piriformis syndrome.

  1. Holistic Treatments

    • Treatment for piriformis syndrome often includes massage and stretching exercises. Strenuous activities, including bicycling and running, should also be avoided. Many physicians recommend physical therapy, generally involving massages, stretching techniques and positions that reduce strain on the piriformis and strengthen the core muscles, including the abdomen and back.

    Medical Treatments

    • Many physicians believe anti-inflammatory drugs and corticosteroid injections to be the most effective in treating a severe case of piriformis syndrome. In extremely severe cases, surgery may be recommended. Physicians may also prescribe the use of an ultrasound, which provides a deeper level of heat than heating packs can provide. In a 2005 study, scientists reported that minimal-access surgery have been widely successful in the treatment of piriformis syndrome.

    Treatment Through Muscle Relaxation:

    • Patients suffering from piriformis syndrome may also find comfort in applying ice and heat to the exterior of the muscle. Ice may help to reduce the onset of pain after completing a strenuous activity, while heat may help to warm the muscles and enhance flexibility. Custom shoes may also help in preventing the injury from recurring. Gait correction may also help in reducing the use of the piriformis muscle while allowing the muscle to relax and heal.

    Expert Insight

    • Over 15 percent of the population has a sciatic nerve that passes through the piriformis muscle rather than below it. Recent studies have concluded that these patients have a greater chance of developing piriformis syndrome, though some scientists dispute these claims, citing insufficient evidence. Failure to treat piriformis syndrome may result in an obturator internus muscle injury, so it is essential to report any incidences of radiating pain down the back of your leg to a doctor immediately.

    Prevention/Solution

    • People who run, bike or complete forward-moving activities often are more likely to develop piriformis syndrome if they do not complete the proper stretches. Lateral stretching and strengthening exercises assist in elongating the muscle and making it more flexible. Scientists also believe that inactive gluteal muscles may also increase the likelihood of developing piriformis syndrome. These muscles are essential to hip extension and the external rotation of the femur. Therefore, it is essential that the muscles are stretched properly before strenuous exercise. Scientists also believe that piriformis syndrome may also be caused by stiffness or hypomobility of the sacroiliac joints. Overpronation of the foot, wherein the knee turns medially and the piriformis activates to prevent over-rotating the knee, may also lead to piriformis syndrome. The disorder is also associated with falling injuries, as these may overextend the piriformis muscle.

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