Piriformis Syndrome

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    What is piriformis syndrome

    Piriformis Syndrome – A neuromuscular disorder occurring when the presence of pain, tingling, and numbness are felt along the sciatic nerve and in the buttocks caused when the sciatic nerve is either irritated or compressed by the piriformis muscle.  Diagnosis of piriformis syndrome is difficult at best due to different anatomical variations in our muscle to nerve relationship.  If signs of sciatica appear without any clear spinal cause, piriformis syndrome could be considered as a possible diagnosis.

    Who Does Piriformis Syndrome Affect

    Fifteen percent of the general population has their sciatic nerve run through their piriformis muscle instead of underneath it.  If you are one of these 15%, studies show that you have a much greater chance of developing piriformis syndrome. 

    Piriformis syndrome may also develop as a result of muscle break down due to inactivity in the gluteal area.  This is often caused by having a job that requires you to sit all day while at work.  This results in the gluteals being deprived of activity, causing the piriformis muscle to perform extra roles it was not designed for.  This results in hypertrophy of the piriformis muscle which produces the symptoms of piriformis syndrome.

    Athletes that engage in forward moving types of activity such as runners and cyclists are more susceptible to developing piriformis syndrome.  Their chances decrease significantly if they work lateral stretches and strengthening exercises into their regular health routine.

    Effects of Piriformis Syndrome

    When the piriformis muscle goes into spasm it can begin to impinge the sciatic nerve and / or the pudenal nerve.  The muscles for your bowel and bladder are controlled by the pudendal nerve.  Compression or entrapment of the pudenal nerve will lead to symptoms of tingling or numbness in the groin and / or saddle area, and in some pudenal nerve entrapment may lead to urinary and / or fecal incontinence.

    In addition to causing pain that radiates from the gluteal down the leg, piriformis syndrome may also produce pain that is able to be relieved by walking with the foot on the side that is involved pointed outward. 

    Causes of Piriformis Syndrome

    One of the more common causes of piriformis syndrome is a combination of weak abductors and tight adductors.  The most effective treatment for piriformis syndrome when this is the cause is stretching and strengthening these muscle groups.  Relief from piriformis syndrome can be felt within days of starting an exercise routine that targets the gluteus medius and hip adductor muscle groups.

    Piriformis syndrome may also be caused by stiffness of the sacroiliac joints, an overpronation of the foot, and can frequently be associated with a falling injury.

    Piriformis syndrome is also referred to as wallet sciatica or fat wallet syndrome.  This is because piriformis syndrome can be aggravated by sitting with a large wallet in the pocket of the affected side.

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