The Tribune

By Dr Susan Donald

PIRIFORMIS syndrome is a condition that occurs when the piriformis muscle - which connects the sacrum or tail bone to the upper femur, or thigh bone - irritates the sciatic nerve.

It is located deep within the buttocks and assists in hip rotation. The sciatic nerve typically lies underneath the piriformis muscle although it is believed that in 15 per cent of the population it lies within the muscle itself. This population is thought to be more susceptible to piriformis syndrome.

Piriformis syndrome is one of the many causes of sciatic pain, which is typically described as pain deep within the buttock that may radiate along the back of the leg and down into the foot. It is more common amongst women and active individuals such as walkers or runners.

The cause of piriformis syndrome is irritation or damage to the piriformis muscle. One type of piriformis syndrome I see frequently is when a patient twists suddenly when getting out of their car or lifting something and twists to put it down. This causes the head of the femur (hip bone) to twist in the hip socket and cause a spasm of the piriformis. This type of piriformis syndrome will cause almost immediate sciatic pain when the patient never had a history of sciatica.

Piriformis syndrome is diagnosed by palpation and symptoms. Palpation will reveal a tight, spasmed piriformis on one side of the pelvis and the other piriformis has normal tone. Symptoms include a dull ache in the mid-buttocks, radiation pain down the back of the legs, pain when walking up stairs or inclines and increased pain after prolonged sitting.

However these are typical symptoms of sciatica and pirformis syndrome is only one cause. Sciatica may be caused by other conditions such as disc herniation, which may be ruled out by x-ray or MRI.

One you have been diagnosed with piriformis syndrome treatment may include adjustment of hip, pelvis, and/or sacrum, stretching, trigger point, heat, ice and physiotherapy. Adjustments will put the pelvis, hip and sacrum and piriformis muscle back to its proper biomechanical position. Stretching of piriformis and hamstring muscles will help break the spasm. Ice will reduce swelling, and massage and trigger point will increase blood flow to the muscle while a range of motion exercises will help re-educate the muscle.

Failure to treat the condition may lead to complications. The body tends to compensate for pain in peculiar ways that may lead to complex conditions that can be difficult, time-consuming and costly to resolve.

If you believe you may have sciatic pain and/or piriformis syndrome, consult your chiropractor.

• Dr Susan Donald practices at Life Chiropractic Centre, Village Road (393-2774).