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How to Treat Piriformis Syndrome

Have you ever heard of such an odd word as piriformis? Although uncommon to most, this is actually a muscle that can cause quite a bit of problems for many people. As a chiropractor I deal with people having problems in this muscle on a daily basis. The piriformis is a deep muscle in the back of the hip, it starts on the lowest part of the spine called the sacrum and then attaches to the back of the hip bone. Many times when a patient comes in and says that they have sciatica, it is actually a piriformis muscle syndrome.

There are a couple things that could cause a piriformis muscle to become a source of pain. When there is a weakness in the back of the hip a trigger point may arise in the piriformis muscle. A trigger point is a tight tender nodule within a portion of the muscle fibers. I usually explain them to my patients as a spasm or a Charlie horse, but only in a small section of the muscle. Also, the spasm in the trigger point is constant, whereas a muscle spasm is in a large portion of a muscle but usually very short lived. Once a trigger point comes on there is a lack of blood flow to that area. This causes the muscle to become painful and many times produces a referral of pain into the low back or down the back of the leg. This type of pain is usually difficult to pinpoint the exact site of pain. These patients usually come in and use their entire hand over their back and say it is a constant dull or achy type of pain. Two common mistakes made with this are heating and stretching. Heat and or stretching are not beneficial for a trigger point and in some instances my make it worse. For a trigger point, ice and or pressure are safer options to easing the pain.

The other possibility for pain is if the entire piriformis muscle becomes overly tight. In about 15% of the population the sciatic nerve runs right through the piriformis muscle. If the muscle becomes too tight it may choke the sciatic nerve giving sciatica type pains all the way down the leg. In this case heat and stretching can be beneficial treatments.

Finally, in either one of these dysfunctions there are many times pelvis restrictions or misalignments that need to be managed. The best option is to be seen by a chiropractor or other physician who specializes in treatment and rehabilitation. Many patients can get relief within one treatment and can also be shown exercises and stretches to minimize the chances of it happening again.