Piriformis Syndrome

The piriformis muscle is a small muscle in the buttock region located near the sciatic nerve. It stabilises the hip joint and helps it externally rotate. Symptoms are reproduced when the muscles go into spasm, the nerve is compressed between the hardened muscle and the bone which give rise to a sharp intense pain in the middle of the buttock that affects almost all movements, also patients complain of radiating pain down the sciatic pathways, commonly called sciatica, which travels down the outer side of the leg, often as far as the ankle and foot.  The pain can occur while sitting on a car seat or running. Pain may also be triggered while climbing stairs, applying firm pressure directly over the piriformis muscle, or sitting for long periods of time. Diagnosis is made by excluding other causes, there is no definitive test for piriformis syndrome. history of repetitive, vigorous activity such as long-distance running, or prolonged sitting in addition to Physical examination using a variety of movements to elicit pain to the piriformis muscle and finally an MRI to rule out other causes are all helpful in the diagnosis. Treatments range from simply avoiding the positions that trigger pain, rest, and ice, physiotherapy to stretch the muscle, anti-inflammatories, and local injections with corticosteroids and or local anaesthetic.