Piriformis Syndrome and Sciatica Nerve Pain

Pirifiormis syndrome can be the cause of severe soft tissue pain, sciatica nerve pain and disability.    If not diagnosed in its early states, piriformis syndrome can become a chronic condition with sciatica nerve pain.  Common sciatica nerve pain is more prevalent than Piriformis syndrome.

What is Piriformis Syndrome

Piriformis syndrome is a neuromuscular disorder.    It occurs when the sciatica nerve is compressed or irritated by the piriformis, a flat, pyramid-shaped and oblique muscle  located deep in the buttocks, and produces sciatica nerve pain.   In 15 percent of people the sciatica nerve travels through the piriformis muscle rather than underneath, increasing the risk of sciatica nerve pain.

What Causes Piriformis Syndrome

Among the reasons for development of piriformis syndrome are:

• Sitting for extended periods of time
• Sitting with a large wallet in the rear pocket
• Repeated forward movements
• Running
• Bicycling
• Stiff sacroiliac joints
• Foot overpronation
• Morton's toe (the second toe next to the big toe is longer than the big toe)
• Falling injury

The primiformis muscle, if overused, becomes tight and compresses on the sciatic nerve with resulting sciatica nerve pain.

Approximately one-half of piriformis syndrome cases are caused by trauma and the remainder are spontaneous onset of sciatica nerve pain.

Symptoms of Piriformis Syndrome

Piriformis syndrome is similar to sciatica nerve pain.     Pain starts in the buttocks and may travel the length of the leg through the back of the thigh and calf and into the foot.    You might experience tingling, numbness, burning and weakness.    The sciatica nerve pain may worsen with sitting or with activities that press the piriformis against the sciatica nerve, such as running or cycling.

Most often, people suffering from piriformis syndrome, do not have lower back pain.

Diagnosis of Piriformis Syndrome

Diagnosis of piriformis syndrome is usually made through physical examination.     Certain tests may elicit sciatica nerve pain indicating the presence of the syndrome.   You may have a shorter leg on the side where the sciatica nerve pain is present.      Your foot on the side where the sciatica nerve pain is may be splayed when you lie on your back.

Treatment for Piriformis Syndrome

Conservative treatment, such as chiropractic, is most often recommended for treatment of the sciatica nerve pain due to piriformis syndrome.      Surgery is rarely required.

Alternate ice and heat treatment may give relief, especially after engaging in an activity that aggravates the sciatica nerve pain. 

Ultrasound treatments by the chiropractor may be beneficial as ultrasound heat penetrates deep into the muscle loosening the tightness and thereby alleviating sciatica nerve pain.

Stretching exercises taught by your chiropractor to target the primiformis muscle, along with the hamstrings and hips muscles, will help increase range of motion and decrease the sciatica nerve pain.

Your chiropractor will also teach exercise techniques to strengthen your core muscles to diminish strain on your primiformis and relieve sciatica nerve pain.

During initial treatment, activities that exacerbate the sciatica nerve pain from the piriformis syndrome should be avoided until your chiropractor approves resumption.