If you have ever experienced a deep, nervy or tingling, pain that starts in the buttocks and may run down through your hamstrings and even all the way down to your foot, there is a good chance that you may have Piriformis Syndrome. Piriformis Syndrome closely resembles the symptoms of a more well-known condition known as Sciatica. The main difference between the two is usually the source of the pain. The pain from Sciatica often comes from the lower back region of the spine, where Piriformis Syndrome is caused from the Piriformis muscles itself.
Piriformis Syndrome is a neuromuscular condition that is caused when the Piriformis muscle, in your buttocks, compresses the Sciatic Nerve that runs directly under it. The Piriformis muscle is a pear-shaped muscle that lies deeper below the Gluteal Muscles and runs from the pelvis to the outer portion of the hip. The Piriformis rotates the hip outward, making the thigh, knee, and foot point outward. Think of a ballet dancer with their legs turned out or doing pirouettes, or a person doing the tree pose in yoga. Your Piriformis helps rotate your hips and legs into this outward rotation. When your Piriformis is over worked or injured, it can cause the muscle to spasm and tighten up. When this happens, the muscle compresses the Sciatic Nerve, causing pain, tingling sensations, and numbness in the buttocks and down into the hamstrings.
Common symptoms of Piriformis Syndrome are:
Sometimes people will think that they have a problem with their hamstring muscles, when it is the hip and gluteal muscles that are tight and tender, not necessarily their hamstrings that is causing the pain they are feeling in their legs. If these symptoms sound like what you are experiencing, talk to your doctor to get a confirmed diagnosis of what may be causing your symptoms.
If you do have Piriformis Syndrome, you will most likely get referred to a Physical Therapist, who will work with you and recommend some stretches and exercises to help reduce the severity of the tight and spasming Piriformis muscle. You may also get a referral to receive massage therapy and acupuncture treatments in conjunction with your physical therapy treatments. Both are great at relieving pain and relaxing tight and spasming muscles. It is highly recommended to do the gentle stretches and strengthening exercises that the Physical Therapist prescribes for you at home. Using heat and/or ice packs on the piriformis is also a common home remedy that is recommended during pain. Ice will help reduce any inflammation and heat can help warm up and relax the muscle.
In more severe and chronic cases, injections and even surgery may be recommended by your doctor. Hopefully between the stretches, exercises, massage therapy or acupuncture treatments, with some self-care at home, you will not have to get to that point. Remember, early detection and diagnosis is best, so do not hesitate to ask your doctor or see your physical therapist is your symptoms last more than week. Acute is easier and faster to address and treat than a chronic condition.
Courtney Truax, LMT is a graduate of East West College of the Healing Arts in Portland, Oregon. She is licensed through the Oregon Board of Massage Therapy and a member of the American Massage Therapy Association. She has her own studio massage practice in the heart of downtown Lake Oswego, Oregon.