Chiropractic Treatment And Piriformis Syndrome
The piriformis muscle is located deep in the buttock. It reaches from the pelvis (sacrum) to the upper part of the thigh-bone (femur).
There are times when this muscle goes into spasm. The cause is often relating to the spine or sacroiliac joints, or from overuse.
This can be a very painful condition and for some people is very disabling. Fortunately, for the majority, chiropractic treatment is very effective.
An accurate diagnosis is always the key to successful treatment.
What is Piriformis Syndrome?
When the muscle contracts it rotates the thigh outwards (external rotation). As with all muscles sitting close to a joint, its main function is to provide stability for the thigh and hip trough a static or isometric contraction. It works in conjunction with several other muscles in the buttock area such as the Quadratus femoris, Obturator internus, Superior- and Inferior gemellus. It is almost impossible to isolate in muscle testing because of it, but it is easy to find and palpate if you know how.
In the majority the sciatic nerve passes immediately below the piriformis muscle, but in a small proportion of people (approximately 15% of the population) part of the sciatic nerve goes through the piriformis muscle.
If the muscle is in spasm this can cause neurological symptoms such as pain, numbness, pins and needles, tingling and weakness due to compression of the nerve. This is called piriformis syndrome.
It is also important to know that the referred pain pattern from the piriformis muscle itself is felt down the leg in a path along the sciatic nerve. It is therefore often mistaken for a piriformis syndrome when it is not.
Quite often it is not even considered as a diagnosis when somebody has Sciatica or leg pain. And the cause of sciatica is often thought to be due to a disc injury. It is, of course, imperative to have an accurate diagnosis to give the right treatment.
So, sciatica can have many causes and it has been shown in many studies that disc herniations can be non-symptomatic. This is where it is easy to get in to a muddle.
Imagine if a disc herniation is visible on a MRI scan and the piriformis syndrome and reffered pain has not been considered as a diagnosis. You have surgery for the disc and low and behold there is no improvement after surgery.
What are the symptoms of Piriformis syndrome?
According to some the piriformis syndrome can cause pain in the lower back, groin, perineum, buttock and hip, and can also cause dyspareunia (painful intercourse) and pain in the rectum during defecation.
But the most common symptoms are pain in the lower back and/or pain that radiates to the buttocks and down the leg.
Often when people talk about the piriformis syndrome they mistake the referred pain from the muscle to be a piriformis syndrome. The difference is that the true piriformis syndrome has neurological symptoms associated with it, such as pain, numbness, pins and needles, tingling and weakness.