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.
Piriformis Syndrome Symptoms
Individuals with piriformis syndrome may experience a variety of symptoms, which may occur intermittently or they may be present chronically. The symptoms of piriformis syndrome are often made worse by prolonged sitting, prolonged standing, squatting, and climbing stairs.
- Pain in the buttock or hip area is the most common symptom.
- Pain may radiate from the buttock area down into the lower leg along the path of the sciatic nerve. Some patients may complain of low back pain.
- There may be numbness and tingling in the buttock area, which can sometimes radiate down to the lower leg.
- Pain with bowel movements may be present.
- Women can sometimes experience painful intercourse.
- There may be tenderness in the buttock area when pressure is applied. Certain patients may have a palpable "sausage shaped" mass in the buttock area from piriformis muscle contraction/spasm.
Piriformis Syndrome Causes
Piriformis syndrome is caused by compression of the sciatic nerve as it passes through the buttock. Typically, this occurs from spasm or contracture of the piriformis muscle. When the sciatic nerve is constricted and irritated, the individual will experience the symptoms of piriformis syndrome.
The piriformis muscle is a flat band-like muscle located deep in the buttock area. It functions to rotate the hip and turn the leg and foot outward. The sciatic nerve is a large nerve that exits from each side of the lower back and courses deep in the buttock region, down the back of the leg, and eventually braches off into smaller nerves ending in the foot. In most people, the sciatic nerve will course beneath the piriformis muscle in the deep buttock area. Normally, the sciatic nerve functions to connect the spinal cord to the muscles and sensory nerves of the legs.
Sciatica is a pain that radiates from the low back down a lower extremity; it is caused by irritation of the sciatic nerve. The sciatic nerve transmits sensation from the lower extremities and lumbar area of the low back. It is common for people to recover from sciatica without a surgical operation.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.