Piriformis syndrome


Have you ever had pain in your rear end, or a tingle down the back of your leg that tends to get worse with pressure on the back of the leg, such as with sitting or even with walking? This can be occurring due to a condition called piriformis syndrome. The piriformis muscle is located in the rear end area and functions to extend, externally rotate, and abduct the hip. It is involved in providing stability to the hip. The sciatic nerve can run underneath or directly through the piriformis and can also be involved if the piriformis muscle becomes dysfunctional.

What can be done to help alleviate the pain from piriformis syndrome? Strengthening and stretching of the piriformis and hip is a typical treatment in physical therapy along with modalities such as electrical stimulation and ultrasound. This may or may not be helpful. What needs to be looked at is WHY the piriformis is dysfunctional. The piriformis becomes dysfunctional due to over use that occurs from abnormal function of the hip and low back. When the glute max and glute medius hip muscles are inhibited and aren’t doing their job because of somatic dysfunction of the low back, the piriformis is one of the muscles that becomes overworked to help stabilize the hip and pelvis. This creates the overuse syndrome of the piriformis, and since the sciatic nerve runs underneath or through the piriformis muscle it can be aggravated causing sciatica down the leg.

Training in osteopathy and manual therapy is imperative to getting proper diagnosis and correction of the pathology. This is due to the spine needs to be looked at for abnormal movement mechanics that causes the glute max and medius muscles to shut down. Explained earlier, when these muscle shut down the piriformis becomes overused, dysfunctional and painful. What will be done at wrightphysiotherapy is the spine dysfunction will be diagnosed and treated using manual therapy. This will let the glute max and medius muscles start working correctly, and then the appropriate exercises will be given to maintain the corrections and to strengthen the system promoting the continued appropriate function of the muscles. When this is done, the piriformis muscle use lessens, letting it relax and calm down. This reduces irritation and the symptoms go away. Unless hands on manual therapy is performed, the body has a very hard time allowing symptom reduction to occur. Manual physical therapy at wrightphysiotherapy is the best option for pain reduction fast!

Physical therapy using manual therapy for treatment of pain.

Hands on manual therapy using osteopathic manipulation techniques is the most effective way to treat orthopedic pain!  The philosophy of osteopathy is to treat the body using manipulation to get the body to function as efficiently as possible, and then work on appropriate strengthening exercises to prevent the pain from returning.  For example, with low back pain the movement of the individual vertebra in the low back need to be improved for normal function and then appropriate core strengthening and stretching needs to be done to allow the body to heal efficiently.