PIRIFORMIS SYNDROME

What is it?
The piriformis muscle stretches from the sacrum to the hip. The piriformis muscle can put pressure on the sciatic nerve and cause pain in the buttock or down the leg.

How does it occur?
The muscle can become tight from an injury and put pressure on the sciatic nerve. In some individuals, the sciatic nerve runs through the piriformis. In this situation, the piriformis muscle can “clamp down” or compress the nerve.

What are the symptoms?
Individuals with piriformis syndrome can have pain in the buttock or down the leg in the course of the sciatic nerve. The symptoms can mimic sciatica or radiculopathy.

How is it evaluated?
A history and physical examination can identify pyriformis syndrome. Occasionally, an EMG or nerve test may be needed. An MRI can identify if the sciatic nerve runs through the piriformis muscle.

How is it treated?
Piriformis syndrome is treated with activity modification, ice and heat. Physical therapy can stretch the muscle and improve its strength, function and symptoms. Trigger point injections and at times, botulinum toxin injections may help.

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