St. Paul Chiropractor Blog

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Piriformis Syndrome


The Piriformis is a muscle on the back of the leg underneath the buttock region. It connects the tailbone to the hip bone underneath the gluteal muscles. When it contracts it extends and rotates the leg and foot (think of pushing a heavy box or pressing on your brake pedal).

Since it is a deeper layer of muscle, it is also closely related to the blood vessels and nerves in the buttock and leg. The large sciatic nerve runs under or sometimes through the piriformis muscle as it travels down the back of the leg. Thus, the tension of the muscle can directly impact the nerve itself.

Piriformis Syndrome

This condition occurs when the piriformis muscle spasms and puts pressure on the sciatic nerve. This irritation of the nerve can result in pain, numbness and/or tingling down the buttock and leg.

A good description clinically can point your chiropractor towards an accurate diagnosis of piriformis syndrome. Assessing the location of pain and certain tests can also aid this process. For instance, if contacting the muscle causes the symptoms to worsen, this may be evidence of its involvement. It is also very helpful to evaluate the lower spine for misalignment and/or dysfunction. Could the structural distortion be causing the muscle problem?

Treatment

Depending on the results of these tests, chiropractic treatment of piriformis syndrome may include stretching of the involved muscles combined with adjusting dysfunctional joints in the hips and pelvis. Imagine if the tailbone that connects to the piriformis is shifted to the side.  Now there is abnormal tension of one of the piriformis muscles which could lead to piriformis syndrome.  Part of the solution could be stretching, but in this case, correcting the misalignment of the sacrum (tailbone) will bring longer lasting relief. Restoring balance to the spine and pelvis is crucial to support the proper alignment and balance to the piriformis as well as the rest of the body.

*EXERCISE DOWNLOAD–>Click Here for Home Piriformis Stretching

Deeper myofascial work including massage can be beneficial as well. Active release therapy involves compressing the muscle tissue while actively moving the muscle underneath the doctor’s contact.  This can be helpful in piriformis syndrome when the muscles is overly tight and spasmed. Other stretches can be helpful and many can be performed at home on a regular basis to give relief while recovering from this painful condition.

Nutritional deficiencies should also be addressed especially if any inflammation is present. Calcium, magnesium and omega 3 supplements may be helpful in these cases.  Hydration should also not be overlooked.  Tissues are less responsive or adaptable when dehydrated and could be more likely to spasm or become inflamed.

*Exercise/stretching disclaimer – Any stretches or exercises shown are for demonstration and may not be right for every individual. Consultation with a chiropractor or doctor is recommended before beginning any exercise program.

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