Piriformis Syndrome May Cause More Than Hip Pain

Introduction

The muscles in our body help us be active when we want to be, rest and repair after activities, and continue to provide everyday movements that help keep the body functioning correctly. For athletes and the general population, physical training and eating healthy foods help deliver fuel to not only the internal organs but also help support the muscles, ligaments, and skeletal joints from injuries. As many individuals start to think about their health and wellness, many factors tend to pop up that can cause them to halt their health and wellness journey. Issues like stress, accidents, traumatic events, and lifestyle habits can affect the body and, over time, can become the risk of developing into chronic problems. An example would be where a person is experiencing hip pain associated with piriformis syndrome. Today’s article looks at piriformis syndrome, how it can cause more than hip pain, and how there are available treatments for piriformis syndrome. We refer patients to certified providers specializing in musculoskeletal therapies to help those with piriformis syndrome. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

What Is Piriformis Syndrome?

Have you been experiencing pain radiating from the buttock down to your legs? Does it hurt when you are sitting down? Or are you feeling tingling sensations and numbness on your butt and thighs? Some of these symptoms might be signs that you might be experiencing piriformis syndrome. Research studies have defined piriformis syndrome as a clinical condition where everyday stress affecting the body causes the piriformis muscle (the small muscle deep in the buttock region) to become tight and irritates the sciatic nerve. When that sciatic nerve becomes aggravated, it can become the risk of developing into sciatica. Many individuals don’t realize that the sciatic nerve also gets affected when their piriformis muscles in the buttock region become overused and tight through strenuous activities. This is due to the belief that any unusual traumatic abnormality in the piriformis muscle will be associated with sciatica symptoms. However, when a person is experiencing buttock pain that travels down the leg caused by the affected piriformis muscle, many will rule out some of the more common causes of sciatica like nerve root impingement triggered by disc herniation.

Surprisingly, three primary causing factors can be associated with piriformis syndrome. The first causing factor is myofascial trigger points may be the results of referred pain (pain or discomfort from another body location). The second causing factor is nerve entrapment against the greater sciatic foramen passing through the various piriformis muscles. And finally, the third causing factor is sacroiliac joint dysfunction due to piriformis muscle spasm. Studies reveal that the piriformis muscle helps stabilize the sacroiliac joint; when the small muscle starts to become irritated, it causes pain in the buttock region. But how does sacroiliac dysfunction relates to piriformis syndrome? Well, since low back pain is associated with sacroiliac dysfunction, the pain will often radiate down to the knee and the groin muscles while becoming a risk of developing piriformis syndrome. 

Piriformis Syndrome Causes More Than Hip Pain?

Due to its broad size in the greater sciatic foramen, the piriformis muscle can become overused and tight, thus becoming piriformis syndrome. Piriformis syndrome can also become a risk to the numerous vessels and nerves that exit out in the pelvis region and may become compressed, causing more than just hip pain. Studies reveal that piriformis syndrome may be masquerading as ischiofemoral impingement triggering extra-articular hip pain by entrapping the quadratus femoris muscle causing groin pain. Another cause that piriformis syndrome is associated with is chronic pelvic pain. How does chronic pelvic pain correlate with piriformis syndrome? Chronic pelvic pain is a non-cyclic pain localized in the pelvis, potentially involving the surrounding muscles like the piriformis muscle supporting the irritated hip joint and pelvis region. Piriformis syndrome could also be an overlapping condition risk of developing other health issues like fibromyalgia in many people. Some conditions have common symptoms associated with piriformis syndrome, including:

• Tingling sensations
• Numbness
• Muscle tenderness
• Pain while sitting
• Discomfort while exercising

The Difference Between Sciatica & Piriformis Syndrome-Video

Have you found it challenging to be comfortable while sitting down doing leisure activities? How about radiating pain that travels down your leg? Or do your hips feel tight and stiff? Experiencing these symptoms means that you might suffer from piriformis syndrome. The video above explains the difference between piriformis syndrome and sciatica. Studies reveal that piriformis syndrome is classically defined as sciatic pain; however, it is not sciatica. Sciatica is caused by compressed sciatic nerve due to herniated disc in the lumbar spine. In contrast, piriformis syndrome is caused when a traumatic injury or an underlying condition causes the piriformis muscle to spasm and aggravate the sciatic nerve. Various factors like prolonged sitting, repetitive movements that involve the legs, and even extensive stair climbing can cause the piriformis muscle to be easily damaged or injured, causing piriformis syndrome. Fortunately, there are ways to alleviate sciatic nerve pain and improve piriformis syndrome.

Treatments Available For Piriformis Syndrome

Many treatments are accessible to manage the pain and discomfort caused by piriformis syndrome for suffering individuals. Some people take over-the-counter medicine to decrease the pain, while others utilize a hot/cold pack on the affected area to relieve discomfort. The symptoms associated with piriformis syndrome usually go away without any additional treatment; however, if the pain or discomfort is still there, many people might benefit from alternative options for treatment, like chiropractic care, physical therapy, or even spinal decompression. Whether it is through gentle stretching, spinal manipulation, or decompression, these treatments are for anyone dealing with piriformis syndrome and its associated symptoms. Physical therapy can help decrease the painful symptoms associated with piriformis syndrome through gentle stretches that help return a person’s range of motion. Chiropractic care incorporates spinal adjustments and manual manipulations to treat various injuries or conditions. Spinal decompression uses traction to gently pull on the spine to release the aggravated nerve from causing pain. The relief can gradually restore a person’s natural health while managing its associated symptoms with various treatments available for individuals with piriformis syndrome.

Conclusion

Piriformis syndrome is a condition where everyday stress affects the piriformis muscle in the buttock region to become irritated and tight while aggravating the sciatic nerve. Many think traumatic abnormalities affecting their piriformis muscle will be associated with sciatica symptoms. However, sciatica is due to nerve root compression triggered by disc herniation. Piriformis syndrome is where that small muscle is overused from various factors that cause more than hip and butt pain. Some overlapping conditions associated with piriformis syndrome can become mediators for groin and pelvic pain. Fortunately, chiropractic care, physical therapy, and decompression can help restore the body gradually by managing piriformis syndrome and its associated symptoms.

References

Hicks, Brandon L., et al. “Piriformis Syndrome.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 21 Apr. 2022, www.ncbi.nlm.nih.gov/books/NBK448172/.

Newman, David P, and Liang Zhou. “Piriformis Syndrome Masquerading as an Ischiofemoral Impingement.” Cureus, Cureus, 16 Sept. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8520408/.

Professionals, Northwest Medical. “Piriformis Syndrome/Sacroiliac Dysfunction.” Northwest Medical Center, 2021, nw-mc.com/piriformis-syndromesacroiliac-dysfunction/.

Ro, Tae Hoon, and Lance Edmonds. “Diagnosis and Management of Piriformis Syndrome: A Rare Anatomic Variant Analyzed by Magnetic Resonance Imaging.” Journal of Clinical Imaging Science, Medknow Publications & Media Pvt Ltd, 21 Feb. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5843966/.

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