Piriformis Syndrome: It’s A Pain In The Butt(ocks)!

If you feel tight stretching across your lower back, the piriformis may be to blame. The piriformis is a flat, triangular shaped muscle that runs parallel to the floor when you’re standing, under the gluteus maximus muscle. It starts at your lower spine and connects with the top surface of each femur. It helps you rotate your hip and turn your leg and foot outward. It across your sciatic nerve directly beneath it so many times a piriformis syndrome is confused with sciatic problems. Because it is so close to the largest nerve in your body, it can cause  pain in some people.

Piriformis Muscle

Whether or not piriformis syndrome is related to mesh surgeries or long hours spent in unnatural positions for many mesh surgeries has not yet been established, but it is often found in personal narratives from mesh-affect women. The exact causes of piriformis syndrome are not yet known but some who treat it suggest it is from: irritation of the piriformis muscle itself, or irritation to a nearby structure such as the sacroiliac joint or hip, tightness or injury of the muscle in response to an injury, or bleeding the the area of the muscle. The piriformis syndrome is believed to be a “functional entrapment syndrome.

•    Pain behind your hip in your buttocks
•    Electric shock-like pain traveling down the back of your leg
•    Numbness in one or both legs
•    Tenderness when pressure is applied t0 your piriformis muscle
•    Pain while sitting on hard chairs

While there are no specific tests to accurately diagnose piriformis syndrome,  doctors sometimes order MRIs and nerve conduction studies, often with normal results. Because it’s so difficult to diagnose, piriformis syndrome is often missed or diagnosed in someone who does not have the condition.

Treatment includes rest, physical therapy to stretch and straighten hip rotator muscles, anti-inflammatory medication, deep massage, or cortisone injections into the area of the pitiformis tendon. Surgery to loosen the tendon is rarely performed and usually only after six months with other treatments which have failed. Recovery from that surgery takes several months.


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