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Piriformis syndrome is a muscular dysfunction that causes sciatic pain (see page on Sciatic Pain). The Piriformis muscle is located in the posterior (back) of the pelvis and in 85% of people the sciatic nerve exits directly behind this piriformis muscle (see diagram left) and in the other 15% of the population the sciatic nerve runs through the belly of the muscle.
This close relationship with the piriformis muscle and the sciatic nerve with any associated muscle spasm, or compression in that area (ex. wallet), overuse or sprain of the muscle, and trauma, may cause Pain, tingling, tightness, and numbness in the buttock and along the path of the sciatic nerve descending down the thigh and into the leg and foot.
Sciatic pain has many causes and can be difficult to diagnose. However there are several diagnostic tests that can be preformed to differentiate piriformis syndrome from various other causes of sciatic pain. Such as palpable tenderness over the sciatic notch, orthopedic evaluation of the area, muscle tests, nerve conduction tests with piriformis muscle involvement, of course our standard CT, MRI, ultrasound modalities as well as
other diagnostic tests will give the chiropractor an idea of what structures may, or may not be involved with the sciatic symptom set.
Once the origin of the sciatic pain has been properly identified as a piriformis syndrome the chiropractic treatment for this muscular condition would be to check and adjust the pelvis to ensure proper alignment of the osseous (boney) pelvic structures, then stretching and exercise the muscle, Ice, ultrasound, and temporarily avoid activities or habits that contribute to the symptoms.Try to avoid these activites while symptoms are present running bicycling, rowing, wearing a wallet in your back pocket, etc... Exercises should be administered on an individual basis depending on the patients dysfunction in the area. However basic core muscle exercises (abs, back) as well as hamstrings and hip muscles, as well as simple stretches that can be preformed at home become very important. Most cases of piriformis syndrome is resolved with a great prognosis with proper chiropractic care and diligence from the patient.