What is the piriformis?
The piriformis is an important muscle of the hip and glutes that helps to rotate your hips to the side and move your hip to the side. The muscle connects from an area on your femur to the sacrum which lies at the base of your spine. The sciatic nerve also flows through this area and with some people even goes underneath the muscles of the piriformis.
Signs and symptoms
Piriformis syndrome is a pain in the butt…literally! Typically pain is experienced in the buttocks or gluteal region and can sometimes radiate down the leg. A person can experience:
- Glute pain
- Pain after activity such as running
- Numbness in the leg or toes
- Pain radiating to the back of the leg
How does it happen?
Piriformis syndrome occurs when the muscle is irritated and tight. This injury is common after long distance running and walking due to the long amounts of time spent fatiguing the muscle. This increased irritation often results in avoiding these painful activities and further weakness to the area. When the muscle is weaker, it is unable to effectively perform the motions required for daily activities including rotating the hip and lateral movement of the hip. Due to the close proximity of the sciatic nerve, when the muscle is tight the sciatic nerve may also experience irritation. Irritation of the sciatic nerve will cause numbness and tingling.
How to treat it?
There are many ways to treat piriformis syndrome:
- Steroid injections – while these are good for short-term relief of pain and decreased inflammation they do not change the weakness or tightness of the piriformis muscle
- Medication – these will also help with short-term day to day activities but do not change the origin of the pain
- Massage – while massage is helpful to loosen the muscle fibers and bring good blood flow to the area for healing, it also will not assist with strengthening the area
- Physical therapy – the most common prescription for piriformis syndrome is PT due to the ability to provide massage to the area and decrease irritability while also strengthening the area and will even provide you with tips and tricks to prevent this from happening again
Why it needs to be addressed NOW
The piriformis is extremely important for daily functions including:
- walking
- standing
- getting in/out of a chair
The piriformis is also instrumental in preventing the low back and knee muscles and structures from taking a larger load. If the problem is not addressed soon, the area of the knee or low back may begin to weaken and fatigue causing further pain. The sciatic nerve may also start to become involved and further pain and numbness and tingling down the leg. All of these symptoms will continue to keep you from your daily activities and what you want to do.
