Do you suffer from a deep pain in your buttock area that sometimes radiates to the back of your leg, which is often called piriformis syndrome? In this blog, I discuss piriformis syndrome, debunk the most common myths about the diagnosis
Piriformis syndrome is usually described as an entrapment of the sciatic nerve by the piriformis muscle that causes localized deep pain, as well as symptoms on the back of the leg. However, because there are several structures that can pinch the sciatic nerve in this area, many researchers and clinicians have come to call the diagnosis “deep gluteal syndrome” as a way of encompassing all possible culprits. Moreover, researchers found no connection between the sciatic nerve variations I just mentioned and piriformis syndrome, contradicting previous beliefs.
That said, except in very rare cases, piriformis syndrome and deep gluteal muscle syndrome probably do not exist in the way most people think they do. This is very important to understand.True compression of the sciatic nerve by the piriformis would be similar to sitting on the toilet for too long, resulting primarily in numbness, tingling or a burning sensation in your leg along the path of the sciatic nerve and its branches.So what actually happens? The best analogy I can give is one I first heard from Tom Jesson, a leading expert in the field.
In most cases, this is what happens in people diagnosed with piriformis syndrome - there is irritation of a nerve or structure in the lower back that contributes to symptoms in your buttock, thigh or along the back of your leg. There are several medical terms for this, such as referred pain, radicular pain and radiculopathy.If it's not the lower back, the second most common culprit is the hip joint itself. For example, a 2004 study by Khan et al. found that although the groin and buttock area are the most common pain locations for people with hip osteoarthritis, people may also report a spread of symptoms into their thigh, knee and even shin or calf.
Why does this matter for physical therapy or rehabilitation? Rolling a lacrosse ball in that area may feel good temporarily, but it's probably not a long-term solution. The same thought process applies here. If the problem has its origin in your lower back, you don't need to focus your efforts on the piriformis. But if massaging or stretching the area feels good and provides short-term relief, it's usually fine to do. Now I don't have a quick fix and I would be wary of anyone offering one, but I can give you strategies to help. Since everyone's situation is unique, our goal is to give you options so you can find what works best for you.
For example; the computer, that's something you need to address. You could change your chair, the height of your chair, the surface you sit on or even how you sit, but the easiest thing to do in this scenario would be to get up and move before the 45 minutes. Apply this reasoning to any postures, movements or activities that contribute to your symptoms. Part of this process may include positions, movements or activities that help relieve your symptoms. For example, someone who describes a worsening of symptoms due to prolonged sitting may report an improvement in symptoms by repeated stretching of the back in a standing position or on the stomach. This is something that can easily be performed periodically throughout the day.Our advice is to discuss your symptoms with your physical therapist and together establish a treatment plan.
