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Have you ever had a pain in the backside? Hamstring Pain? Or Any ‘Sciatic’ type Symptom?

Updated: Oct 17, 2017

If you have then you may not have ‘Sciatica’ you may be suffering with something completely different – ‘Piriformis Syndrome’. The symptoms of Piriformis syndrome often become present when a nerve (sciatic nerve) running from the back, through the glutes (buttocks) becomes aggravated by a muscle in the glutes called ‘Piriformis’ (hence the name ‘Piriformis Syndrome’). Due to the highly similar symptoms as a lumbar vertebrae disc bulge irritating the sciatic nerve (sciatica) people often are mistakenly diagnosed with Sciatica and not Piriformis syndrome.

So where is this pesky Piriformis Muscle?

The suspected muscle starts from the inside edge of your sacral area (the sacrum is the triangular shaped bone at the base of the spine) and travels across diagonally to the upper outside of your hips (If you feel from your waist line down the outside slowly with firm pressure it’s the bone that sticks out the most just around 3-8cm from your waistline).

What on earth does the Piriformis Muscle do?

This muscle can be tricky on times, when standing tall the muscle laterally rotates your hip (when standing keep your leg straight and then tense at the glutes – your foot should turn outwards, that’s essentially lateral rotation or external rotation). When seated or if your legs are bent (hip flexion) your piriformis is now a medial rotator of your hip (Lie or sit down with your legs bent around 90 degrees and then tense the glutes notice your knee wants to turn in towards your midline (medial rotation or internal rotation).

Do I have Piriformis Syndrome?

Without coming in to the clinic at Body Solve and having a consultation/examination with one of the Osteopaths or Sports Therapists there is no definite answer whether or not you have this condition. However if you have any of the following symptoms it could be a sign that there is something underlying and you should definitely seek a diagnosis from your local Sports Therapist or Osteopath: · Sensation resulting in pain down one side of the leg, often in the back of the leg starting from the buttock radiating downwards but often radiating around the side or possibly from the lower back itself (this is why it can be tricky to diagnose). · The sensation of pain is increased with any extensive use of the hip, it can also be increased with periods of sitting and walking. · A patient with Piriformis syndrome will often focus their buttock onto the unaffected side when they are sitting to alleviate the pain on the affected side (this is a classic sign someone has hip/glute/issues). · Other symptoms and signs include one foot rotated outward more than the other side which is a sign of a highly short and tight piriformis muscle.

Why is my Piriformis being overworked?

Here are some of the causes of an overworked Piriformis:

  • Gluteal underactivity (underactive buttock muscles) – misfiring gluteal muscles can lead to a host of issues that we will cover in a later article. Ensure that your glutes are part of your primary engines. Get them fired up by engaging the glutes in your everyday life along with whatever sport or activity it is you do.

  • Weak stability proprioceptors. Your larger muscles are doing a lot of work however the much smaller muscles need work to; focus hard on technique and form and these proprioceptors will be firing.

  • Poor biomechanics of the feet, people who over pronate in the foot (have an inward turning foot) usually develop hip issues at some point during they’re life. Have your biomechanics looked at by your local running footwear shop (if they offer this service). Our sports therapists are trained in looking at the biomechanics of the foot so come along and get checked out.

Okay, please tell me how not to get Piriformis Syndrome

Usually this syndrome is caused by an overworked Piriformis. Overworking any muscle makes it become strong yes, but very fatigued and tight and in most cases short. Preventative measures are as follows:

  • Regular rest periods and working different muscle groups

  • Improved form and technique

  • Daily stretching or yoga practice

  • Knowing your body – research and read up on the various muscles you are working, specifically if your sport, hobby, interest or occupation is repetitive. Many patients who attend Body Solve have issues that have been created with repetitive motion over many years.

How can I get a diagnosis of Piriformis Sydrome?

Almost all cases will be diagnosed after a consultation and examination with your sports therapist or osteopath. The examination will assess your lumbar spine (spine of your lower back) followed by an assessment of the hip. It doesn’t take long to diagnose Piriformis syndrome and get treatment started to the road of recovery. Your therapist should look to reproduce the symptoms of piriformis syndrome in a controlled manner before setting a treatment plan in place along with home care advice and exercises.

What’s the Treatment for Piriformis Syndrome? Following a thorough assessment including consultation, movement assessment and clinical testing your therapist will begin treatment.If your diagnosis is positive for Piriformis Syndrome then a treatment with an osteopath or sports therapist could include any of the following:

  • Realignment of the skeletal system

  • Deep tissue massage techniques to the soft tissues around the affected area.

  • Mobilisations of spine and hips

  • A homecare advice plan including stretches and exercises.

  • Referral to a foot orthotics specialist if your gait or biomechanics are not correct.

Treatment with one of our osteopaths at Body Solve may also include:

  • Manipulations to the spine or peripheral joints

  • Dry needling (a form of treatment using acupuncture needles).

Will I ever get rid of Piriformis Syndrome?

We see this kind of ailment at Body Solve weekly, with great results for people affected by Piriformis syndrome and in many cases there are vastly reduced symptoms after a single session. Patients who have long standing biomechanical issues and instability may take a little longer to overcome the symptoms of piriformis syndrome. If you would like a free consultation or are unsure if we can help with any symptoms you have, please don’t wait for it to worsen. Give us a call, text or email on 07542 367102 and at the very least have a chat with us.

Thanks for reading – Body Solve – Pain Free Living.

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