For some people, prolonged sitting or standing and one-sided movement cause pain in the back and buttocks. If the pain is persistent and occurs repeatedly during exercise, piriformis syndrome is a possible cause. Find out about the causes and treatment methods here.
Find selected specialists for piriformis syndrome.
Piriformis syndrome is a constriction of the sciatic nerve caused by the piriformis muscle. The result is sometimes severe pain that radiates into the legs. Tingling and numbness can also occur.
Piriformis syndrome is a neuromuscular disorder that some people confuse with other conditions such as sciatica or a slipped disc.
Possible triggers for the constriction of the sciatic nerve are
The exact triggers cannot always be clarified. Piriformis syndrome is usually caused by a contusion in the buttock area. This is because this is where the piriformis muscle protrudes from the pelvic bone and covers the sciatic nerve.
This is why the pain occurs along the entire area where the sciatic nerve is supplied.
People with piriformis syndrome often suffer from pain, numbness and tingling sensations in the buttocks. In many cases, the pain and discomfort radiates to the thigh, calf or foot.
The pain often occurs when sitting. Sometimes, however, it also occurs when climbing stairs, jogging or cycling. In principle, any posture or movement can trigger the pain if it leads to firm pressure over the piriformis muscle.
Movements or postures with bent legs are often responsible. This is why some people also experience discomfort when sleeping. Side sleepers who bend their legs a lot are particularly affected.
If those affected bend their legs less or stretch them out for a long time, the symptoms usually subside.
The pain of piriformis syndrome usually occurs unilaterally in the buttocks and lower back and as leg pain @ Microgen /AdobeStock
First of all, the doctor conducts a medical history interview with the patient and asks them about their symptoms. This is followed by a physical examination. In some cases, the doctor can feel a strong tension in the piriformis muscle . Patients often also react sensitively to pain.
There is currently no test to detect piriformis syndrome . It is therefore a diagnosis of exclusion. The doctor must ensure that the symptoms are not caused by another illness.
Possible other diseases are
To rule out these diseases, the doctor will carry out further examinations using imaging techniques.
Although it is not possible to detect piriformis syndrome directly with imaging procedures, it is possible to rule out other diseases.
The first step is to avoid postures and movements that trigger or intensify pain and discomfort.
If pain occurs when sitting or during certain movements and activities, it makes sense to change posture.
It is advisable to take a temporary break from sporting activities that cause discomfort. Relaxation exercises and heat or cold applications can help to alleviate the pain.
Patients who sit a lot should stand up every 20 minutes to stretch the muscles in the buttock area.
Sometimes the doctor will prescribe anti-inflammatory medication to relieve the pain. Medication to relax the muscles (so-called muscle relaxants) may also be considered.
Depending on the extent of the symptoms, the doctor may advise an injection of painkillers or anti-inflammatory glucocorticoids.
Physiotherapeutic measures can also be used to reduce the symptoms. The physiotherapist stretches and works on the surrounding muscles or the trigger point in the gluteal muscles.
Patients also learn correct posture during physiotherapy. They learn exercises and stretches that are specifically for the piriformis muscle. The patient should also perform these exercises at home.
Physiotherapy for piriformis syndrome @ New Africa /AdobeStock
Loosening the muscles with heat before the stretching exercises is helpful. To avoid further irritating the nerve, you should only perform gentle stretches.
Ultrasound treatments also help to reduce the discomfort. In severe cases, surgery is also possible, in which the doctor cuts the piriformis muscle.
The course of piriformis syndrome depends on the underlying cause. As a rule, however, patience is required, as it usually takes longer for an improvement to set in.
Long-term therapeutic success can be expected if the doctor recognizes and treats the cause as well as the symptoms. Misalignments are usually the cause and lead to muscular imbalances. In this case, it is necessary to correct the misalignment. A posture school or stability training can have a positive influence on the success of treatment.
Piriformis syndrome is usually the result of sports and movements that put strain on the piriformis muscle.
If you want to prevent piriformis syndrome, you would have to refrain from such sports. However, as this is not a solution, there are a few things you need to bear in mind when doing sport.
The following tips can therefore help prevent it:
If you experience pain, you should take a break until the pain subsides.
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