Piriformis syndrome can cause symptoms of sciatica with pain and weakness that you feel in the back of your buttock radiating along the back of your thigh.
These symptoms of sciatica are very similar to sciatic pain from a herniated disc or other problem in your lumbar spine. Disorders of your lower back and problems with the piriformis muscle can both irritate the sciatic nerve and cause the same or very similar symptoms.
Consider the Anatomy
Pain and other symptoms can develop when the piriformis muscle is irritating the sciatic nerve. To understand why and how this happens we need to look at the anatomy.
The piriformis muscle is a small muscle that runs across the back of your buttock. It is attached on the inside of your pelvis.
It passes through an opening in the back of your pelvis called the sciatic notch, and connects to your greater trochanter, which is that boney part of your hip that sticks out on each side.
It is one of the many muscles that move your hip and give it motion in many directions. It is called an external rotator because it rotates your hip externally.
The problem with the piriformis muscle is that it runs right across the top of the sciatic nerve, and in some people this large nerve actually passes through the piriformis muscle. So anything that affects the piriformis muscle may also affect the sciatic nerve.
Compared to the other large muscles around your hip and buttock, the piriformis is relatively small. It is easily overpowered and certain activities, especially vigorous sports, can cause it to become strained or stretched.
Other possible causes of pain related to the piriformis muscle include prolonged sitting on a hard surface, or trauma such as a blow to the upper buttock, These may also affect the piriformis muscle and the sciatic nerve.
When this muscle becomes inflamed or begins to spasm it can cause pressure on the sciatic nerve. This is what causes the pain, weakness and other symptoms of Piriformis Syndrome.
Treatments for Piriformis Syndrome generally focus on the piriformis muscle. Initially, rest is usually prescribed until the symptoms subside. Applying cold packs to the painful area may also be helpful to reduce swelling and inflammation as well as relieve pain.
When you are an athlete it may be very difficult for you to rest this area while continuing to compete or maintain your level of fitness. Unfortunately, returning to vigorous activities without giving your injury sufficient time to heal is a common cause of recurrent symptoms.
Begin Gentle Stretching Exercises
As your symptoms start to improve you can start some gentle stretching exercises, as long as they do not make your pain worse. If stretching makes things worse you may need to give it more rest and more time for the muscle to heal.
When you are able to tolerate gentle stretching you may also begin to introduce some light strengthening exercises. Evaluation and treatment by a physical therapist can be very helpful. They can teach you specific exercises for the piriformis muscle and help you decide how fast to advance your treatment.
When symptoms are severe, or do not seem to be improving some doctors will perform steroid injections in and around the piriformis muscle. This is intended to speed healing and reduce pain by relieving inflammation. Unfortunately, even these treatments are not always helpful
Patience and Rest are the Keys
You need to have patience when treating Piriformis Syndrome because rest and time are the keys to healing.
Athletes who are too anxious to get back in the game will cause a flare up of their symptoms and Piriformis Syndrome can become a chronic condition for some people.