The piriformis muscle is a flat triangular shaped muscle that originates on the sacrum (lower end of the spine) and attaches to the hip joint. It is one of six muscles in the hip region that rotates the leg outward in the hip socket. It works in coordination with other muscles to provide pelvic stability during weight shifting in walking. The sciatic nerve is a thick nerve that runs underneath the piriformis muscle and branches down into the legs and feet, providing sensation and motor function. Piriformis syndrome is a condition when the piriformis muscle compresses the sciatic nerve, causing pain in that region and sometimes sciatica of the affected side.
- Pain in the buttocks that may radiate to the leg
- Pain triggered by sitting, walking, climbing stairs, or squatting
- Prolonged sitting
- Vigorous repetitive activities (e.g. long distance running)
- Trauma to the hip or low back
PHYSICAL THERAPY FOR PIRIFORMIS SYNDROME
Physical therapy treatment will consist of therapeutic ultrasound, myofascial release, deep tissue massage, and manual stretching to decrease spasms of the piriformis muscle. This will help reduce compression of the sciatic nerve. To avoid further irritating the muscle, you will also be advised to hold off on running or other strenuous activities until your pain and symptoms improve. When appropriate, your therapist will introduce progressive strengthening exercises for the core and hip muscles as part of your therapy routine. If you wish to return to long-distance running or sports, your therapist will devise a training program that will allow you to gradually and safely resume your activities without pain.