A rare neuromuscular disorder, piriformis syndrome is when the piriformis muscle compresses the sciatic nerve. The piriformis muscle is a flat muscle — almost like a rubber band — located in the buttock region near the top of the hip joint. This muscle plays a key role in lower body movement — enabling walking and shifting of weight from one foot to the other. It works to stabilize the hip joint by lifting and rotating the thigh away from the body. It plays an essential role to nearly every movement of the hips and thighs.
Piriformis syndrome is usually misdiagnosed myofascial pain. None of the symptoms attributed to piriformis syndrome differentiate the cause between nerve compression and fascia injury. The pain of either disorder can best be described as acute tenderness in the buttock region coupled by intense pain down the back of the thigh, calf and foot. Patients often feel pain in the back of the thigh, calf and foot. It can be especially painful when you walk up stairs or inclines. You may also feel some discomfort sitting. The pain can be relieved by lying down on your back. Ultimately, successful treatment involves healing a lifetime of muscle and fascia injuries to the gluteal muscles and tendons.
Your doctor may conduct radiologic tests such as MRIs to rule out other causes of sciatic nerve compression, such as a herniated disc.
Therapy & Treatment
The good news is that treatment for piriformis syndrome tends to have a positive prognosis. Cold packs and stretching can provide relief because cold makes you numb and stretching can unkink the fascia. Regenerative medicine therapy to heal old fascia injuries can be life changing as the pain goes away.
Stretching the piriformis muscle is key. To do this, lie on your back with both feet flat on the floor and knees bent. Grasp your knee with your left hand and bring it towards your left shoulder — hold and stretch. Repeat on each side. Other stretches and self treatments are described in the book ‘Winners Guide to Pain Relief.”
Another helpful stretch involves lying on your back. Place both feet flat on the floor with your knees bent. Rest your right leg ankle across the knee of your left. Next, pull your left thigh close to the chest. Hold this position and stretch out your muscles. Repeat each side.
You can also stretch the hamstring to alleviate any associated sciatic pain. Place two chairs facing together. Sit in one chair and place your leg on the other. Gently lean forward until you feel the stretch in your thigh. Easy does it — don’t overdo it.
You can also lie on your back and straighten both legs. Wrap a towel around one foot and pull the leg up, holding onto the towel. You should feel a mild stretch along the thigh. Repeat for each leg.
Start out easy on yourself — gently hold each stretch for 15 seconds, gradually increasing to half a minute as the stretch becomes more accommodating. Repeat each stretch 3 times each day. All of these stretches have limited effectiveness. They all are done by pulling on the ends of a muscle. Pain comes from the kink in the middle, and pulling hard on the ends will tighten the kink