Piriformis Syndrome: What You Need to Know
Your piriformis muscle is located in the buttocks. If it becomes inflamed or strained, piriformis syndrome develops. The muscle spasms and creates pain in the buttock region. It can also irritate the sciatic nerve. This will cause numbness to radiate through the leg.
Your piriformis muscle begins at the base of the spine. It connects to the top section of each thighbone (femur). It helps to rotate your hip. Additionally, this muscle helps turn legs outward. The piriformis muscle runs diagonally. Many think the sciatic nerve runs through it. However, it actually sits directly below the muscles.
Causes of Piriformis Syndrome
The exact causes are unknown. However, doctors believe the causes may include:
- Tightening of the muscle from injury or spasm
- Swelling of the muscle from injury or spasm
- Irritation to the muscle
- Irritation to a nearby structure such as the hip
- Bleeding in the piriformis region
Each of these can cause piriformis spasms and pain. The nearby sciatic nerve may also be affected. Your sciatic nerve is irritated if you feel radiating tingling in the leg.
Symptoms of Piriformis Syndrome
Acute tenderness in the buttocks is the main symptom. Additional symptoms you may experience include:
- Sciatic pain down the leg
- A dull ache in the buttock
- Reduced range of hip motion
- Pain when walking upstairs
- Severe pain after prolonged sitting
Most symptoms get worse after prolonged sitting. Walking and running can also exacerbate pain. Lying down can make symptoms feel better.
Diagnosing The Condition
Doctors look at your medical history first. They also need to perform a physical exam. Sometimes, diagnostic testing should be done. In most cases, other causes need to be ruled out. Several conditions can cause similar symptoms. Lumbar disc herniation, for example.
A review of your medical history covers symptoms. Are there positions that make the pain worse? Or better? How long you have had symptoms is also important. You also need to discuss any injuries you have had. A family history of conditions like arthritis is also a good idea to check on.
A physical exam involves looking at the hips and legs. And small movements are often evaluated for pain. In fact, a physical exam can rule out other conditions. It also identified weak points, tenderness, and muscle strength.
X-rays are the most common diagnostic tests. Imaging will identify sciatic nerve damage. MRIs and nerve conduction tests are also commonly performed. They can rule out other conditions too. And, an injection of anesthetic can also be used, with or without steroids. However, this can help identify if the piriformis muscle is the cause of pain.