Doctor's Notes on Piriformis Syndrome
Piriformis syndrome is a condition where the sciatic nerve is compressed or irritated by the piriformis muscle. The most common signs and symptoms of the condition are pains in the buttock or hip area. Numbness may occur. Pain and numbness can radiate down to the lower leg. Some patients may have pain with bowel movements, and some women can experience pain with intercourse. Palpation of the buttock may reveal a mass that is a sign of spasm or contraction of the muscle.
The cause of piriformis syndrome is the direct pressure on or irritation of the sciatic nerve by contractures or spasms of the piriformis muscle.
What Are the Treatments for Piriformis Syndrome?
The main conservative treatments are the first three listed below and the remaining are for more refractory symptoms. They are as follows:
- Physical therapy: massage for pain relief
- Exercise restores muscle strength.
- Stretching improves flexibility.
- NSAIDs: pain relief, decrease inflammation
- Muscle relaxants decrease muscle spasms.
- Injections (for example, corticosteroids, Botox) decrease spasms.
- Electrotherapy: electrical current to reduce pain and spasms
- Surgery: Cut the piriformis to stop pain.
Your doctor will design a treatment plan that may include two or more of the above. Surgery is the last option.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.