Piriformis Syndrome

spinal stenosis

Piriformis syndrome is a condition in which the piriformis muscle becomes tight or spasms, and irritates the sciatic nerve. This causes pain in the buttocks region and may even result in referred pain in the lower back and thigh. Patients often complain of pain deep within the hip and buttocks, and for this reason, piriformis syndrome has also been referred to as "Deep Buttock" syndrome.

What is the Piriformis?

The piriformis is a small muscle located deep within the hip and buttocks region. It connects the sacrum (lower region of the spine) to the top of the femur (thigh bone) and aids in external rotation (turning out) of the hip joint.

Many muscles and tendons make up the hip and buttocks region. The piriformis is the horizontal muscle in the center, running over the top of the sciatic nerve.

What Causes Piriformis Syndrome?

Piriformis syndrome is predominantly caused by a shortening or tightening of the piriformis muscle, and while many things can be attributed to this, they can all be categorized into two main groups: Overload (or training errors); and Biomechanical Inefficiencies.

Overload (or training errors): Piriformis syndrome is commonly associated with sports that require a lot of running, change of direction or weight bearing activity. However, piriformis syndrome is not only found in athletes. In fact, a large proportion of reported cases occur in people who lead a sedentary lifestyle. Other overload causes include:

• Exercising on hard surfaces, like concrete;


• Exercising on uneven ground;


• Beginning an exercise program after a long lay-off period;


• Increasing exercise intensity or duration too quickly;


• Exercising in worn out or ill fitting shoes; and


• Sitting for long periods of time.

Biomechanical Inefficiencies: The major biomechanical inefficiencies contributing to piriformis syndrome are faulty foot and body mechanics, gait disturbances and poor posture or sitting habits. Other causes can include spinal problems like herniated discs and spinal stenosis. Other biomechanical causes include:

• Poor running or walking mechanics;


• Tight, stiff muscles in the lower back, hips and buttocks;


• Running or walking with your toes pointed out.

Symptoms

Pain (or a dull ache) is the most common and obvious symptom associated with piriformis syndrome. This is most often experienced deep within the hip and buttocks region, but can also be experienced anywhere from the lower back to the lower leg.

Weakness, stiffness and a general restriction of movement are also quite common in sufferers of piriformis syndrome. Even tingling and numbness in the legs can be experienced.

In the second part of this two part series, I will discuss treatment methods for piriformis syndrome, as well as go over a few tips for prevention. Often a few moments of carefully thought out warm-ups or stretches will save you a lot of pain in the future.