Piriformis Syndrome is one of the most common causes of Sciatica. Sciatica is nothing but pain in the buttocks that traverses down the leg and is caused by irritation of the spinal nerves in and around the lumbar spine. This nerve irritation can be far down in the leg. This syndrome is usually painful but can be treated with proper diagnosis and medication. However, in some rare cases, surgery is required to tackle this situation.

Causes of Piriformis Syndrome

The syndrome arises when the piriformis muscle squeezes and irritates the sciatic nerve in the lumbar spine region. However, the exact reason why this happens is still a mystery. Doctor’s believe that when the piriformis muscles tighten and spasm, they squeeze the nerve up against the pelvis bone causing irritation. There have also been cases where injury to the buttock has causes this situation in the muscles. Eventually, these injured muscles are replaced by scar tissue which is not as elastic as the original muscle, hence the sciatic nerve continues to stay squeezed and causes irritation. 

Symptoms of Piriformis Syndrome

One of the most common symptoms is the pain that spreads down the back of the leg. This pain could be felt on either sides or just one. In some cases, changes in sensation, weakness in the leg, and even vague tingling sensation may be experienced down the leg. Usually, people affected by this syndrome have difficulty sitting; and even when they sit, they can almost never sit comfortably.

Diagnosis of Piriformis Syndrome

Diagnosis of this situation is quite complex and begins with the evaluation of medical history and physical examination. Posture checks, movement checks, observation of the patient's seating position, injuries in the past, and several other details are observed and evaluated.  Apart from this, doctors also check skin sensation, reflexes, blood tests and muscle strengths as it is very important that the right condition be diagnosed for the right treatment. Patients are also usually asked to have an x-ray taken of their low back and pelvis. Some other tests like the MRI, neurography, bone scan, or using the diagnostic injection technique are also accurate.

Treatments for Piriformis Syndrome

Treatments could be non surgical or surgical followed by rehabilitation. Nonsurgical treatment includes medications such as ibuprofen and naproxen, which are anti inflammatory drugs; and Tylenol. This could be followed by exercises to treat the condition. In case the pain continues, injections with lidocaine or cortisone are also prescribed. In certain cases, Botulism injection therapy is also followed, the effects of which could last for a few months.  Surgical treatment is usually used as a last resort in which the piriformis tendon might be cut. After the treatment, whether surgical or non surgical, it is very important that the patient keeps visiting their physician regularly for a while and continues with physical therapy as long as necessary.