Piriformis syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed or otherwise irritated by the piriformis muscle. This causes pain, tingling and numbness in the buttocks and along the course of the sciatic nerve. The syndrome may result from anatomical variations in the muscle-nerve relationship, or from overuse or strain.
In 15% of the population the sciatic nerve passes through the piriformis muscle, rather than underneath it. These people have a far greater incidence of piriformis syndrome than does the general population.
Inactive gluteal muscles also facilitate development of the syndrome. These are important in both hip extension and in aiding the piriformis in external rotation of the femur. A major cause for inactive gluteals is unwanted reciprocal inhibition from overactive hip flexors (psoas major, iliacus, and rectus femorus). This imbalance usually occurs where the hip flexors have been trained to be too short and tight, such as when someone sits with hips flexed, as in sitting, all day at work. This deprives the gluteals of activation, and the synergists to the gluteals (hamstrings, adductor magnus, and piriformis) then have to perform extra roles they were not designed to do. Resulting hypertrophy of the piriformis then produces the typical symptoms.
Treatment begins with stretching exercises and massage, and the avoidance of contributary activities such as running and bicycling. We recommend formal physical therapy, including the teaching of stretching techniques, manual massage, and strengthening of the core muscles (abs, back, etc.) to reduce strain on the piriformis muscle.
Call to make an appointment today:
Dr. Erik Rosenberg, D.C. – 858-279-2121