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My physical therapist says I have buttock pain from piriformis syndrome. My doctor says there's no such thing. Which is it?
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Piriformis syndrome: what is it? How do you get it? How do you know you have it? How do you get rid of it? What else do you need to know? That's the substance of a recent review article written by two well-known and well-respected physical therapists on the subject of piriformis syndrome.
Let's start with: what is the piriformis syndrome? The piriformis muscle is a flat, pyramid-shape structure. It starts along the anterior (front) part of the sacrum and inserts or attaches on the greater trochanter of the femur. That's a bony bump at the top of the upper thigh bone. It is close enough to the sciatic nerve that it can either put pressure on the nerve. In about 10 per cent of all cases, the sciatic nerve actually runs through the piriformis muscle. Anytime the muscle contracts, the nerve gets squeezed.
Some experts think it's this pressure that causes the symptoms that make up piriformis syndrome. Those symptoms include aching, burning, or sharp pain in the area controlled by the sciatic nerve. The pain starts in the mid-buttocks on one side and can shoot down the upper leg. Symptoms may go down as far as the knee but only occasionally go past the knee. How far down the leg the pain goes can help distinguish it from a herniated disc. Pain that does go past the knee down to the foot is more likely to be from a protruding disc putting pressure on the spinal nerve root.
Before going much further, it's important to say there are some medical specialists who don't believe the piriformis syndrome even exists. So, some effort has been put into identifying just what constitutes the idea of a piriformis syndrome. Here are six indicators of this condition:
History of trauma to the buttock or sacroiliac area
Pain in the sacroiliac joint or area of the piriformis muscle
Pain that's made worse by stooping or lifting and relieved with spinal traction
A soft nodule that is easily felt in the area of the SAI joint
A positive straight leg raise test
Atrophy or wasting of the buttock (gluteal) muscle
In time, researchers will be able to find tests that are accurate and sensitive enough to clearly identify musculoskeletal problems that cause problems like the piriformis syndrome. That will put to rest the debate about does it or doesn't it exist. For the patient with buttock pain, something is causing those symptoms, regardless of what we call it.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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