Do you have a dull ache or pain in your buttock when you sit down for a long time or when you are walking up stairs or inclines? Does your hip mobility feel limited? Does your pain occasionally go down the back of your thigh or your leg?
If you answered yes to either of these questions you might have piriformis syndrome.
What is Piriformis Syndrome?
The piriformis muscle is a deep muscle in your buttock region that connects your thigh bone at the hip to the tailbone and lower back. This muscle runs diagonally upwards from the hip and is located beneath the gluteals. When this small muscle tightens up and/or spasms, this can cause a pain in the buttock. This is called Piriformis Sydrome. In addition to pain in the buttock, the sciatic nerve can become irritated and symptoms of sciatica such as pain down the back of the thigh, leg and foot can appear. The sciatic nerve runs vertically from your low back down the back of your thigh and can either pass behind the piriformis muscle or right through this muscle. The close relationship of the sciatic nerve and piriformis muscle is the reason why many individuals with Piriformis syndrome are misdiagnosed. The sciatic nerve can get compressed and/or irratated in many different places: 1) The low back, 2) The Piriformis Muscle, 3) Anywhere along the back of the leg. It is important that a qualified health care professional, such as a chiropractor assess you to determine where your scaitica is originating from so that treatment can be specific to the site of injury.
What Causes Piriformis Syndrome?
Below are some reasons why your piriformis muscle may be in spasm and be causing you to experience pain in your buttock:
1. Fat wallet
The problem is you might actually have a fat wallet. Many men often put thick wallets in the back pockets of their pants. Being creatures of habit you usually put your wallet in the same back pocket everyday. When you sit on your thick wallet it puts extra pressure on the piriformis muscle and shifts your pelvis. If you sit for long periods of time like a truck driver or office worker you may be aggravating your piriformis muscle and giving yourself piriformis syndrome. The easy solution is to take the wallet out.
2. Fall on your buttock
If you have recently fallen on your buttock you may have either brusied your piriformis muscle or caused damage to the structure of the muscle which may have healed inappropriately and with scar tissue. This can cause spasm in the piriformis muscle. Additionally, a fall to the buttock can shift the bones in your pelvis (including your tail bone) which the piriformis normally connects to. If the bones are shifted, they could be putting additional strain on the piriformis muscle because the muscle is forced out of it’s optimal length in order to accommodate a new resting length position. The piriformis will react to this by going into spasm or developing trigger points.
3. Hip Dysfunction or SIJ Dysfunction
If you are experiencing issues with your hip or SIJ condition your piriformis muscle may need to overcompensate or work harder in order to help you manage with this pain or injury. Limping can also put more strain on your piriformis muscle. Ultimately, correcting your hip problem or SIJ dysfunction and improving the muscle control and balance in this region can take some of the strain off the Piriformis muscle and allow it to work the way it was made to.
4. Improper Sitting
For some of you sitting long periods will tighten the piriformis muscle. Many of you put more pressure on one buttock vs. the other with more weight on one side. Crossing your legs or shifting your body to one side repeatedly can cause this. This will put increased pressure on your piriformis muscle as well as your sciatic nerve. And you will end up with piriformis syndrome.
Treatment for Piriformis Syndrome
First off, you need an experienced and skilled health care practitioner like the folks at Rebalance to assess your body. You need to determine what the root of the problem is and if it is infact Piriformis syndrome that you are suffereing from. Once you have been correctly diagnosed, your chriopractor or physiotherapist will be able to apply treatment strategies that include manual therapy and acupuncture as well as muscle strengthening to correct the issue.
Your therapist may work on releasing your piriformis muscle or mobilizing the joints that are contributing to the tight piriformis muscle such as your hip, your SIJ or your low back joints.
Medical acupuncture can be used to stimulate the sciatic nerve and increase blood flow and conduction within the nerve bringing it back to health.
Your health provider will determine what muscles are too tight and which are not strong enough and might be placing additional load on the piriformis muscle. It is important to note that everyone is unique and your muscle imbalances will be assessed individually. This means that the prescriptive exercises that you are given will be unique to you and will help only you!
For more information or to book an initial consultation with Dr. Ken or our other health care practitioners please contact us or request an appointment online. Our team of qualified and highly skilled chiropractors, physiotherapists and sports massage therapists are here to help you recover from your injury. Our team has a lot of experience dealing with Piriformis Syndrome as well as a wide variety of other conditions and you can be rest assured that we are 100% committed and dedicated to our work and to helping you feel your best! Book today.
Written By: Dr. Ken Nakamura CAFCI, DC – Sports Chiropractor at Rebalance Sports Medicine
Dr. Nakamura also writes a blog at www.bodiempowerment.com