Piriformis Syndrome

Piriformis Syndrome

Postural misalignment is the most common reason for this painful issue. Symmetry can stabilize and balance the misalignments. 

My video below is to help increase mobility and tightness of the hips. Tightness in this muscle can compress the sciatic nerve and cause pain in the buttocks and hip. There can also be numbness and tingling or weakness.   It occurs when the sciatic nerve is irritated by a tight piriformis muscle. So stretching in this case can help. However, if you get any of the symptoms mentioned above while doing this exercise you need to stop, see your doctor and ask for the tests below. My personal first choice is to see my chiropractor when I feel anything abnormal structurally.

When looking at the picture above you can imagine that any misalignment, injury, tightness or inflammation can cause the sciatic nerve to become irritated (I mean really MAD!). As I mentioned above, it will let you know by way of pain into the buttocks and hip and even shooting pain down the leg that it is not happy and needs relief. Piriformis syndrome can be a chronic condition, a one-time injury, or a recurring source of pain. The cycle can go on and on.  In almost 95% of  piriformis syndrome cases, it all starts as a response to poor posture, overuse and repetitious movement. (Are you sitting too much?)

 As you can see, the piriformis muscle is deep on each side of the hip that extends from the base of the spine ( anterior Sacrum) to the top of the thigh (Greater Trochanter).

The sciatic nerve is the largest single nerve in the body.  It extends from each side of the lower spine down through deep in the buttocks into the back of the thigh and all the way down to the foot. It serves a vital role in connecting the spinal cord with the leg and foot muscles.

The first thing that you should do it you have any of the symptoms mentioned above is to get a true diagnosis for Piriformis Syndrome. The symptoms mirror sciatica and low back issues. Piriformis syndrome is a somewhat controversial diagnosis. Doctors have argued that it is both under and over diagnosed.

Many doctors diagnose piriformis syndrome based on symptoms alone.  Two tests that are available can boast significant evidence to support what it truly is. These tests are:

Magnetic Resonance Neurography: This form of magnetic resonance imaging (MRI) test looks for inflammation in the nerves.

Fair Test: This flexion, adduction, and internal rotation test flexes the hip to stretch the piriformis and compress the sciatic nerve. It measures delays in sciatic nerve signals due to its compression under the piriformis.

Remember this injury mimics symptoms of other injuries like a disc bulge or sciatica which is a back injury and not piriformis syndrome. So make sure you are dealing with the right problem.  It could be a herniated disc injury.

Chiropractic, acupuncture, massage all can help, but many times it re-occurs. The pelvis needs to be stabilized and that is where SYMMETRY comes in. I stabilize and balance the areas with the greatest deviations first to begin the reprogramming process (brain and body).  Most times this begins with the pelvis. Click here to download my 4 easy movements to begin. If you have any of the above symptoms do not do the 4th exercise until you check with your doctor.

Avoiding the activities that aggravate it such as sitting for too long as this can slow the healing process. You must adopt a consistent approach of stretching and releasing what is tight, quickly followed by strengthening what is weak. My suggestion is to work with a professional that is trained in corrective exercise.

Here is your checklist when working with a corrective exercise/postural therapist:

Stabilize the hip and reprogram the brain to give the piriformis muscle a break. Give me a call for a free Mini-Consult.

Reprogram movement patterns. Begin with the Four Easy Movements.

a. Strengthen the weak muscles and stretch the tight muscles.

b. Continue to strengthen the posterior kinetic chain. This includes the back muscles, hamstrings and buttocks.

c. Eliminate pore habits such a not drinking enough water. (Did I mention sitting too much?) 

d. Avoid temporarily any of  the activities that have caused the flareups.

e. Take a close look at your exercise program. It may not be right for you temporarily or even long term.

Wishing you a healthy pain free life,



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