Piriformis Syndrome

Piriformis Syndrome is a neuromuscular condition which can be caused by a recent injury or an abnormality within the hip joint. 

Cause

1. Injury to the butt region which causes inflammation in the tissue, muscle spasms or both resulting in nerve compression.
2. Overuse of piriformis muscle
3. Repetitive trauma from sitting on hard surface, aka “wallet neuritis”
4. Sudden or gradual spasm of piriformis muscle or compression of sciatic nerve. 
5. What population or sports mostly is this seen in?
   1. Long-distance running/walking; skiers, tennis players, long distance bikers

Risk Factors

1. Condition can be caused by an abnormality in the hip (small population has this condition)
2. More commonly seen in women than men because of the wider hips
3. Prolonged sitting, stair climbing, repetitive squatting and rising, and a recent increase in activity can all be predisposing factors.

Signs and Symptoms

1. Dull ache in the midbuttock region
2. Pain that worsens at night especially when turning from side to side
3. Difficulty walking up stairs or on an incline
4. Weakness and numbness extending down the back leg
5. Pain when sitting longer than 15-20 minutes
6. Hip may feel like it is ‘rotated’

Diagnosis

1. Expect an EMG to be ordered
   1. Used to determine between Piriformis Syndrome or a intervertebral disc herniation
2. MRI may be used next

Treatment 

1. NSAIDS
2. Physical Therapy
3. Ice, Rest
4. Local Steroid Injections
5. Surgical Decompression