Conditions We Treat
Piriformis Syndrome
What Is It?
Piriformis syndrome occurs when the piriformis muscle, located deep in the buttocks, compresses or irritates the sciatic nerve.
It is a neuromuscular condition rather than a spinal disorder, but it can closely mimic sciatica caused by lumbar disc pathology.
Symptoms
- Deep buttock pain, typically on one side
- Radiating pain down the back of the thigh
- Pain worsened with sitting, squatting, or hip rotation
- Tenderness over the piriformis muscle
- Possible numbness or tingling in the leg
Diagnosis
- Physical exam with symptom reproduction using maneuvers such as the FAIR test
- MRI to rule out lumbar disc herniation or hip pathology
- EMG in select cases to differentiate from lumbar radiculopathy
Treatment
Conservative Options:
- Stretching and physical therapy targeting the piriformis and hip rotators
- NSAIDs or muscle relaxants
Interventional Options:
- Trigger point injections or botulinum toxin injections to reduce muscle spasm
- Postural and ergonomic correction
Surgical Options:
- Rarely required
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