Among hip and lower back pain patients, around 10 to 15% of these would encounter pain as a result of Piriformis Syndrome, referred to as piriformis pain. Unlike nerve impingement disorders like sciatica, stenosed spinal foramen and canal, and spinal abnormalities like scoliosis, lordosis, and kyphosis, this particularly is a neuromuscular condition.
In a small percentage of lower back pain sufferers, the sciatic nerve moves through the muscle rather than under it, so that muscle contractions and spasms constrict or suffocate the nerve, resulting in pain.
At work, when sitting for long hours a day, the gluteal muscles become inactive further aggravating the situation. Over activity in the psoas major, iliacus and rectus femoris muscles can manifest when the hips are flexed for too long at the expense of the gluteals such as the gluteus minimus and the obturator internus. The synergist muscles of the gluteals, namely the hamstrings, adductor magnus, and the piriformis, will have to function a lot more which they were not meant to do. This disease mechanism causes the piriformis to hypertrophy producing pain.
Symptoms of the Syndrome. Piriformis pain is indicated as intense pain in the gluteal (buttocks) region that may expand down to the leg. Undertaking exercises that are performed in a sitting position, such as bicycling and rowing, and also while running or just basic walking can trigger pain. Piriformis syndrome should be diagnosed if the pain is relieved by walking with the foot on the affected side pointed outward and if pain manifests or present pain is irritated by sitting with a large wallet within the rear pocket on the impacted side.
Diagnosing the Condition. Piriformis pain is determined scientifically by extending the irritated muscle and inducing sciatic nerve compression through physical exam techniques like the Race and Freiberg maneuvers. Though imaging techniques cannot specifically help in identifying Piriformis Syndrome, these can help eliminate herniated discs, spinal stenosis, facet arthropathy, and lumbar muscle strain. The MRN or the Magnetic Resonance Neurography is the only imaging procedure that can detect Piriformis Syndrome. This technique could see the presence of the aggravated sciatic nerve at the level of the sciatic notch where the nerve goes through the muscle.
Treating Piriformis Pain. There are obviously, many conservative treatments that are shown valuable in relieving piriformis pain. These treatments are… * NSAIDs and/or muscle relaxers * Stretches and other soothing exercises * Massage therapy * Cold compresses at the beginning of pain accompanied afterwards by hot compresses * Osteopathic and chiropractic adjustment
Injections of anti-inflammatory drugs and/or steroids, local anesthetics (such as lidocaine), botulinum toxin (BOTOX), or a combination of the three may be offered if traditional treatments are unsuccessful. Though surgery is seldom suggested, the entrapped sciatic nerve can be released from the muscles with the latest procedures of minimally-invasive surgeries.