> Piriformis Syndrome
What is the Piriformis Muscle?
The piriformis is a muscle
located in your buttock area that is one of the hip
"rotators." In other words, it assists when
you lift your leg to the side and then rotate so that
your toes are pointing up. The sciatic nerve, the main
nerve to supply your leg, runs close to, and sometimes
through, the piriformis muscle.
Piriformis syndrome is a condition in which the sciatic
nerve becomes inflamed or irritated as a result of a
problem with the piriformis muscle. This can cause pain
in the buttock and, more commonly, down the back of
The piriformis muscle lengthens and
contracts when you are walking or running, which can
cause it to enlarge and crowd the sciatic nerve. Prolonged
sitting, or driving a car for long periods of time,
can cause the piriformis muscle to contract and shorten,
disrupting the smooth movement of the sciatic nerve.
Although incorrect or incomplete stretching or warmup
exercises before athletic activity can lead to irritation
of the piriformis muscle, with resultant sciatic nerve
pain, most pain comes after prolonged activity.
There are usually three parts to an
orthopedic evaluation: medical history, physical examination,
and tests your physician may order.
To help achieve an accurate diagnosis,
your physician will ask you to describe your injury
and symptoms, including the location, severity, and
duration of your pain; what aggravates your pain and
what you do to relieve it, and any history of previous
trauma or treatment. You also may be asked about other
medical conditions, such as diabetes and allergies,
and medications you currently are taking. Your physician
may ask you about your physical and athletic goals –
information that will help him decide what treatment
might be best for you in achieving those goals.
| PHYSICAL EXAMINATION
may start by feeling around your hip and buttock area
to assess tenderness of the piriformis muscle. You may
also be asked to lie on your side with the affected
side on top and your upper leg bent slightly. If you
raise your top leg about eight or ten inches and experience
pain while holding that position, you may have piriformis
syndrome. To test for pain or weakness, your physician
may employ resisted abduction – putting pressure
on your leg from the side as you push out against it
– while you are in a sitting position. Another
test for piriformis syndrome is to check for pain while
you twist your body with your feet planted, as if you
were serving a tennis ball.
X-ray or MRI
(magnetic resonance imaging) may be used to rule out
other causes of radiating leg pain, such as a herniated
disc or tumor.