Piriformis is a muscle deep in the buttock. The sciatic nerve comes from the bottom of the back, on its way into the leg it runs close to the piriformis muscle, and in a percentage of people actually passes through the muscle. If for any reason the piriformis squeezes the nerve it causes pain deep in the buttock. This is called piriformis syndrome and is often effectively treated with piriformis stretches.
Piriformis syndrome can be caused either by direct trauma, for instance a fall onto the buttock which leads to bleeding and bruising into the muscle and consequent pressure onto the nerve, or a repetitive injury. A link has been shown with piriformis syndrome a repeatedly keeping ones wallet in a trouser back pocket and spending long periods of time sitting on it!
Symptoms of Piriformis Syndrome
- Pain in the buttock
- Pain radiating down the back of the leg into the hamstrings
- Pain on stretching the hip inwards
- There is no muscle weakness. Compression of the sciatic nerve at the lumbar spine rather than as it passes piriformis can cause muscles in the thigh, feet, big toe or calf to be weak.
Treatment of Piriformis Syndrome
One of the mainstays of treatment of piriformis syndrome should be piriformis stretches. The main difficulty here is finding a stretch that effectively targets the muscle, your physiotherapist should be able to try out a range of stretches with you to target the one that will have the best result.
Other treatments that have been proposed for piriformis syndrome include:
- Anti- inflammatory medication
- Using heat, for instance sitting on a wheat bag. Heat is often used to warm up a muscle prior to stretching
- Trigger point release. The muscle can gain a state where it is continually contracted, putting pressure on a point in the muscle called the trigger point is exquisitely tender, but can cause the muscle to release. Sitting on a squash ball and rolling it around under the buttock can be effective
- Injection. Some practitioners advocate the use of injection into the muscle of either local anaesthetic, or botox.
- Surgical release. Considered a last resort by most the piriformis can be released surgically
- Lower limb kinetic chain. In those were piriformis syndrome is caused by repetitive usage over time it is important to look for contributory causes including poor foot position, decreased nerve mobility, or poor core stability.
Disclaimer: The information on this page is written to help you manage your buttock pain. There are several possible causes for buttock pain and should you have any concerns you should always seek advice from a qualified health professional such as a Chartered Physiotherapist or your GP.