A health condition that causes pain or numbness in the butt, hip, or upper leg is called piriformis syndrome. It occurs when the piriformis muscle presses on the sciatic nerve. However, this syndrome can also occur due to muscle spasms, swelling, injuries, scar tissue in the piriformis, and other causes. Furthermore, most cases of this disorder go away within days or a few weeks with rest and simple treatments.
A flat and narrow muscle that begins in the lower spine and goes through the butt to the top of the thighs is called the piriformis muscle. This muscle extends to each side of the body and helps with almost every movement of the lower body. However, the sciatic nerve usually goes underneath the piriformis. It travels from the spinal cord through the buttocks and then down to each leg. In addition, the sciatic nerve is the longest and largest nerve in the body.
Generally, this syndrome occurs rarely, and according to some research, about 0.3% to 0.6% of lower back pain is caused by piriformis syndrome.
Symptoms
The symptoms caused by this syndrome often occur in the buttocks, hips, or upper leg. Usually, people describe the feeling as:
- Numbness
- Painful
- Burning
- Aching
- Tingling
- Shooting
In most cases, the symptoms worsen during the following activities. Examples include:
- Climbing stairs
- Walking
- Running
- Sitting for a long time
If any of the previous symptoms occur without an obvious reason, do not hesitate to visit a doctor.
Causes
Anything that puts pressure on the sciatic nerve can cause this syndrome. While the most common causes of piriformis syndrome are inflammation (swelling) in the piriformis or the tissue around it, muscle spasms, and scarring in the muscle, it can also be caused by other causes. Injuries to the piriformis muscle can also occur in the following cases. For example:
- Climbing stairs, walking, or running without strong enough piriformis muscles
- Injuries to the hips, buttocks, or legs from falls or motor vehicle accidents
- Tight muscles caused by a lack of physical activity
- Lifting something heavy improperly, which can cause damage to the piriformis muscle
- Not warming up before physical activity or stretching properly afterward
- Long-distance running or performing repetitive movements
Sometimes, people may develop piriformis syndrome due to abnormal anatomy of the piriformis muscles. In such cases, the condition is called primary piriformis syndrome.
What Are The Possible Complications of Piriformis Syndrome?
In some cases, people with piriformis syndrome may also experience some complications. Check below some of them:
- Chronic pain
- Functional limitations (such as sitting, walking, or driving)
- Incorrect diagnosis – In some cases, piriformis syndrome can be mistaken for other disorders, such as a lumbar disk herniation.
- Muscle spasms and tightness
- Urinary or bowel dysfunction
- Pelvic osteomyelitis
The previous list does not contain all possible piriformis syndrome complications. In any case, you can consult with your healthcare professional about ways to reduce the risk or prevent previous complications.
How to Prevent Piriformis Syndrome?
There are some strategies that may help prevent recurrent episodes of this disorder. Examples include:
- Regular physical exercise to keep the muscles healthy
- Good posture, especially when sitting, driving, or standing
- Lifting things properly by bending the knees, squatting, and making sure your back remains straight
- Warm up before physical activity
- If you should stay for long periods, it is advised to take breaks by standing, walking, or stretching
Diagnosis
Usually, it is challenging to diagnose this syndrome, and doctors perform multiple examinations and tests to rule out other disorders that cause similar symptoms. They may also ask some questions about the symptoms, activity habits, and medical history to get more clues about the disease. In general, there are no specific tests to confirm this syndrome, but physicians often perform imaging tests to get detailed images of the piriformis muscles and sciatic nerve. These include:
- CT (computerized tomography) scans
- MRI (magnetic resonance imaging) scans
- Ultrasound
- EMG (electromyogram)
Treatment
While doctors prescribe different treatments for people with piriformis syndrome, they can include the following options. For example:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Home exercises that help stretch or strengthen the piriformis muscles
- Several days of rest
- Massage, as a complementary medicine
- Medicines to relax the muscles
- Physical therapy
- Steroid injections
- Botulinum toxin injections
Commonly, healthcare professionals do not recommend surgery for people with piriformis syndrome. However, it can be an option when previous treatments do not work. During this procedure, surgeons will remove scar tissue and other sources that put pressure on the sciatic nerve.
Home Remedies
Your doctor may also recommend some remedies along with treatment to ease the symptoms and improve the recovery time. These include:
- Do not participate in activities that trigger piriformis syndrome, including riding a bike
- Massage deep into the tissue of the hips and buttocks
- Regularly stand up from a chair
- Administer NSAIDs exactly as recommended by your doctor or according to the package directions
- Apply cold packs or heat to the affected area
- Stretch piriformis and surrounding muscles
Frequently Asked Questions
How long does piriformis syndrome last?
Usually, it goes away within a few days with lifestyle changes and simple treatments. However, it is very important to follow your doctor’s recommendations because the condition can easily return. In more severe cases, without treatment, this condition can impact the ability to function properly.
What is the difference between piriformis syndrome and sciatica?
While both conditions are related to the affected sciatic nerve, they are different. Sciatica is often caused by a herniated disk or spinal stenosis, and the symptoms mostly occur in the lower back and can then spread to the buttocks and legs.
When should I see my healthcare provider?
You should visit a doctor if any of the following symptoms or health problems occur. For example:
- Frequent trips or falls because of pain or numbness
- Pain lasts longer than a few weeks
- Inability to control your bowels or bladder
- Sudden and severe pain in the lower back or leg
- Weakness or numbness in the back or leg
- Injuries to the back, hip, or leg
- Difficulty picking the foot up off the floor
If you have additional questions, ask your healthcare provider.
