What is Piriformis Syndrome?

Piriformis syndrome is a disease that causes low back pain. The piriformis muscle is located in the buttocks of the human body. Because its shape is similar to a pear, the fat in the buttocks is called pear-shaped muscle. Piriformis syndrome generally refers to the pain symptoms caused by long-term squeezing of the buttocks due to long-term sitting. Therefore, in life, we should exercise more, stretch our muscles, and enjoy massage services when necessary.

Piriformis syndrome is a common disease causing acute and chronic sciatica. It is generally believed that the high branch of the common peroneal nerve passes through the piriformis muscle bundles or the sciatic nerve passes through the belly of the piriformis muscle. When the piriformis muscle is injured and becomes congested, edematous, spasmodic, adherent and contracted, the intermuscular space or the upper and lower holes of the muscle become narrowed, squeezing the nerves and blood vessels passing through them. The resulting series of clinical symptoms and physical signs are called piriformis muscle injury syndrome.

Causes

Buttocks trauma bleeding, adhesion, scar formation; drug injection causing piriformis muscle degeneration and fiber contracture; acetabulum posterior superior fracture displacement and excessive callus can all cause compression of the sciatic nerve at the piriformis muscle. In addition, in a small number of patients, the sciatic nerve has a distorted course when it leaves the pelvis and passes through the piriformis muscle. However, the strong contraction of the muscle during external rotation of the hip can put excessive pressure on the sciatic nerve, resulting in chronic sciatic nerve injury over time.

Clinical manifestations

Pain is the main symptom of this disease, mainly in the buttocks and may radiate to the lower limbs. In severe cases, the patient cannot walk or the pain becomes severe after walking a certain distance and the patient needs to rest for a while before continuing to walk. Patients may feel that the pain is deeper and radiates mainly to the back or posterolateral side of the ipsilateral lower limb. Some may also have numbness on the outer side of the calf and discomfort in the perineum. In severe cases, the buttocks will experience "knife-like" or "burning" pain, difficulty bending the legs, lying on the knees, and difficulty sleeping at night. The pain in the affected limb will be aggravated by increased abdominal pressure when urinating, defecating, coughing or sneezing.

treat

Non-surgical methods include massage therapy, local blockade, intramuscular injection, physical therapy, Chinese herbal medicine, acupuncture, etc. Massage therapy is the main method for treating piriformis syndrome, which can significantly improve symptoms and relieve patients' pain. When using manual therapy, you must first choose the correct area. The patient can lie prone with both lower limbs extended backward to relax the waist and hip muscles. The surgeon draws a line from the posterior superior iliac spine to the greater trochanter of the femur. The point 2 cm directly below the midpoint of the line is where the sciatic nerve exits the inferior foramen of the piriformis muscle, and the two sides of the line are the piriformis muscles. Local blockade has a certain effect in relieving pain.