Piriformis syndrome is a condition in which the piriformis muscle irritates the sciatic nerve and causes pain in the rear and may cause pain along the back of the leg and into the foot (similar to sciatica pain). Piriformis syndrome is most common among women, and is thought to be common among active individuals (such as runners and walkers).
The piriformis muscle is a small muscle located deep in the rear (behind the gluteus maximus).
The piriformis muscle:
- Starts at the lower spine and connects to the upper surface of each femur (thighbone).
- Functions to assist in rotating the hip.
- Runs horizontally, with the sciatic nerve running vertically directly beneath it.
Piriformis syndrome can develop when the piriformis muscle becomes tight or spasms and places pressure on the sciatic nerve that runs beneath it. The pressure on the sciatic nerve can cause low back pain and/or pain that radiates to the rear and down the leg (similar to sciatica pain). From a technical standpoint, piriformis syndrome does not cause true sciatica (as sciatica is usually defined as a radiculopathy, or compression of a nerve root as it exits the spine). However, just like sciatica, piriformis syndrome can cause pain, numbness and tingling along the sciatic nerve, which runs down the back of the leg and into the foot.
A common symptom of piriformis syndrome is pain along the sciatic nerve, so it is often thought that piriformis syndrome causes sciatica. However, piriformis syndrome does not involve a radiculopathy - a disc extending beyond its usual location in the vertebral column that impinges or irritates the nerve root - so it is technically not sciatica. Instead, it is the piriformis syndrome, it is the piriformis muscle itself that irritates the sciatic nerve and causes sciatic pain.
The piriformis is a muscle located deep in the hip that runs in close proximity to the sciatic nerve. When the piriformis muscle becomes tight and/or inflamed, it can cause irritation of the sciatic nerve. This irritation leads to sciatica-like pain, tingling and numbness that run from the lower back, to the rear and sometimes down the leg and into the foot.
Stretching the piriformis muscle to is almost always necessary relieve the pain along the sciatic nerve and can be done in several different positions. A number of stretching exercises for the piriformis muscle, hamstring muscles and hip extensor muscles may be used to help decrease the painful symptoms along the sciatic nerve and return the patient's range of motion.
Several of the stretching exercises commonly prescribed to treat sciatica symptoms from piriformis muscle problems include:
Spine piriformis stretches
- Lie on the back with the legs flat. Pull the affected leg up toward the chest, holding the knee with the hand on the same side of the body and grasping the ankle with the other hand. Trying to lead with the ankle, pull the knee towards the opposite ankle.
- Lie on the floor with the legs flat. Raise the affected leg and place that foot on the floor outside the opposite knee. Pull the knee of the bent leg directly across the midline of the body using the opposite hand or a towel, if needed.
- Lie on the floor with the affected leg crossed over the other leg at the knees and both legs bent. Gently pull the lower knee up towards the shoulder on the same side of the body.
Buttocks stretch for the piriformis
- Begin on all fours. Place the affected foot across and underneath the trunk of the body so that the affected knee is outside the trunk. Extend the non-affected leg straight back behind the trunk and keep the pelvis straight. Keeping the affected leg in place, scoot the hips backwards towards the floor and lean forward on the forearms.
All of the piriformis stretching exercises should be held for 30 seconds and repeated 3 times.
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The information in the booklet is not intended as a substitute for medical advice but is to be used as an aid in understanding ailment. Always consult your doctor about your medical condition.