Piriformis Syndrome - A Basic Understanding

Piriformis syndrome is something you may hear athletes and runners toss around during conversations however it isn’t reserved strictly for runners.  Piriformis syndrome is actually a neuromuscular disorder that is the result of the Piriformis muscle compressing your sciatic nerve. 

To understand Piriformis syndrome it helps to understand what the Piriformis muscle is.  It is a flat muscle that is located at the back of your hip joint and the back of your pelvic wall.  Your sciatic nerve runs from the bottom of your spine around the back of your hip joint and down the back of your leg. 

In about 10-20% of the population the sciatic nerve passes through the Piriformis rather than underneath it however this doesn’t mean those people will automatically have Piriformis syndrome.  As people with normal sciatic nerves and those with sciatic nerves which run through the Piriformis both can develop Piriformis Syndrome and conversely people with a sciatic nerve which runs right through the muscle can live their whole lives without sciatica.

 What causes the Piriformis to compress or irritate the sciatic nerve is still being studied however there are several theories

One theory seems to indicate that people with inactive gluteus muscles may have a higher incidence of Piriformis syndrome however that doesn’t explain the diagnosis for runners and athletes who presumably have very well developed gluteus muscles.

Stiff muscles can also be linked to causing Piriformis muscles as can overpronation which again can cause the muscles, the Piriformis muscle specifically, to become tight. 

Another common thread amongst people suffering from Piriformis Syndrome is an imbalance in muscles.  For example, most people are right or left handed and they’re also right or left leg dominant too.  This leads to the muscles in one leg becoming more developed and stronger than the other.  For most people this isn’t something that is physically noticeable however it causes the other leg to have to compensate which results in tight muscles and quite often sciatica and Piriformis Syndrome. 

Now we’ve mentioned Sciatica a few times here and it’s important to know that sciatica isn’t a diagnosis but rather a symptom.  Much like a runny nose is a symptom of a cold or the flu.  Sciatica presents itself as pain radiating from the hip and down the back of the leg, numbness or tingling from the hip and down the back of the leg or a burning feeling in the same location.

Once you’ve been diagnosed as having sciatica (remember it’s a symptom and not a condition) then a Piriformis Syndrome diagnosis may follow.  Sciatica is caused by many things including: herniated disks, spinal injury, spinal stenosis and Piriformis Syndrome amongst other things. 

Treatment for Piriformis Syndrome includes balancing the strength of your muscles, building muscle strength in your core, buttocks and legs, and maintaining those well balanced muscles for a pain free life. 

Click on this link to learn more about Piriformis syndrome pain