What is the Piriformis Muscle and Sciatic Nerve?
The Piriformis muscle attaches from an area low down on the spine within the pelvis called the sacrum and inserts on the top of the thigh bone (femur). It plays a role to move and stabilise the hip joint and pelvis. A number of nerves that branch out from the lower segments of the spine combine together to form the Sciatic Nerve which passes immediately next to the Piriformis muscle, or in some cases directly through the muscle, before making its way down the back of the thigh.
When the Piriformis muscle becomes tight or inflamed this can cause irritation of the sciatic nerve and produce symptoms. This muscle can also respond to hip or lower back injuries and become irritated. In the case that the sciatic nerve passes through the actual Piriformis muscle belly then the symptoms of Sciatica or Piriformis Syndrome are more likely.
Symptoms of Sciatica/Piriformis Syndrome:
Deep buttock pain in one side only, rarely both sides.
Shooting, burning or tingling sensation travelling down the back of the leg, past the knee and sometimes into the foot
Numbness of the posterior thigh/leg and into the foot
Increased pain in buttock/posterior thigh when bending forward or straightening leg out
Treatment of Sciatica/Piriformis Syndrome:
Reducing muscle tension of the Glutes (buttock) and Hamstrings – this can be done by massage, dry needling and/or pain-free stretches
Improving the mobility of the lumbar spine – joint mobilisation by a physiotherapist, and gentle, passive movements into pain-free directions such as extension or rotation to improve mobility are commonly prescribed
Neural Sliding techniques – a technique prescribed by physiotherapist to improve the nerve’s movement between these muscles and joints. These should be done gradually and within pain-free range of motion
Behavioural and postural changes – Adjusting workplace, car seat etc. as well as day to day behaviours to reduce prolonged slouching, excessive leg straightening or bending of the lower back that will irritate/stretch the sciatic nerve.
This condition can be quite tricky to treat and a combination of many treatment options may be used over a period of time to ensure the best recovery possible.
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