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Piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle can also irritate the sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (very similar to sciatic pain).
The Piriformis is a muscle that connects your pelvis to your hip. It’s a deeper muscle located in in the gluteal area. The piriformis stabilizes your pelvis and hip. This means when your pelvis and hip need control, the piriformis kicks in to stabilize along with a symphony of other muscles.
If you peel away the gluteus maximus, you have a layer of muscles that rotate the hip. One of those muscles is the piriformis, which connects the pelvis to the hip. The sciatic nerve is located under your piriformis. There are other nerves in that area called the cluneal nerves.
Piriformis symptoms usually happens on one side of the body, but some people can experience it on both sides.
Symptoms can be triggered by walking, going up or down the stairs, lifting the leg out to the side, rotating or turning the hip, past sports injuries, walking long periods of time or sitting for extended periods of time.
Piriformis Syndrome doesn’t just occur in athletes – it can happen to people who are sedentary or pregnant. It can occur in people at any age.
The pelvis is made up of many different joints. If these joints are not moving properly, this can contribute to piriformis syndrome.
Your body is designed to adapt and compensate so that you can continue to move and function. Things like injury, a sedentary lifestyle, pregnancy or back issues might cause your body to adapt. However, certain muscles can also overcompensate.
Many muscles attach to the pelvis. From above, the muscles of the abdomen, the back, the diaphragm and the pelvic floor all connect to the pelvis. From below, the muscles of the spine and leg connect to the pelvis. All these muscles need to work together in a balanced way to help you move.
However, if all of these muscles are not working in harmony, the Piriformis muscle will kick in to help control the hip, spine and pelvis. After a while, it will get overworked and spasm, develop trigger points, which are knotted spasming within a muscle that prevents good blood flow and causes pain down the leg.
When the piriformis muscles become too tight, they press on different nerves and cause pain and tingling down into the back of the leg. Eventually, whenever the muscle is used, it causes pain.
Just stretching, strengthening or massaging the Piriformis muscle doesn’t always work, all the muscles that attach to the pelvis might need to be worked. The muscles surrounding the piriformis might be overly tight or weak. It’s important to work with a holistic physical therapist to balance the surrounding muscles. This will take stress off the piriformis and allow the pain to subside so the muscle can function better.