Piriformis syndrome
Piriformis syndrome arises many controversial opinions: some experts believe it doesn’t exist, while others are all for diagnosing and treating it. For the purposes of this article, we will assume that it is a real condition. Piriformis syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed or irritated by the piriformis muscle; this is the muscle in the gluteal region of the lower limb. Pain, tingling, and numbness in the buttocks and along the path of the sciatic nerve that descends down the lower thigh and into the leg, are associated with this syndrome. This article will discuss the symptoms, causes, how it’s treated, prognosis, and why it’s a controversial diagnosis.
Symptoms of Piriformis Syndrome
As mentioned above, pain, tingling, and numbness in the buttocks and into the leg is common in piriformis syndrome. Other symptoms include tenderness in the area of the muscle itself; pain that radiates down the back of the leg, touching the hamstrings and calf muscles; and reduced range of motion of the hip joint.
Causes of Piriformis Syndrome
The piriformis muscle is a small muscle in the buttock region that is responsible for rotating the leg outward; it runs from the base of the spine to the thigh bone. The sciatic nerve runs very close to this muscle, sometimes even through the muscle fibers of the piriformis muscle. When the muscle becomes tight, for a variety of reasons, it can squeeze, irritate, compress, and/or put pressure on this nerve, causing the symptoms mentioned above. The cause of this discomfort can possibly be because of anatomical variations in the muscle-nerve relationship, or from overuse, or strain.
How it is Treated
Symptom relief can come in a variety of ways. One thing is to try non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin, or naproxen; muscle relaxants, which have to be prescribed, can be useful as well. Stretching exercises, massage, and avoidance of certain activities (biking, running, etc.) will certainly increase the rate at which the symptoms are alleviated. Physical therapy is often recommended by health care providers when treating patients with piriformis syndrome. Using a hot or cold compress may offer temporary relief for some individuals. When none of these work, injections can be administered, such as a local anesthetic, anti-inflammatory drug, corticosteroids, botulism toxin, or a combination of the three.
Prognosis
The prognosis for individuals with piriformis syndrome is generally quite good. Once the pain is alleviated and the symptoms addressed, individuals can resume normal activities. It is important to keep up with exercises to prevent recurrence or worsening of the pain.
Controversy Concerning Piriformis Syndrome
Many people believe that this syndrome is too similar to other conditions, the most common one being sciatica. Sciatica is the name for the pain caused by the sciatic nerve. So, it doesn’t really make sense why one would cancel out the other. Sciatica refers to the symptoms, while piriformis syndrome refers to the muscle that can cause the pain. However, there aren’t any confirmatory tests to verify the syndrome, which presents another argument against piriformis syndrome. It seems that there are sufficient symptoms that could classify piriformis syndrome as an actual condition.
To help get around the dilemma, there are certain physical findings that may assist in confirming piriformis syndrome: a piriformis muscle spasm detected by deep palpitation; a rectal examination may reveal a tenderness on the lateral pelvic wall; a painful point may be present at the lateral margin of the sacrum; shortening of the involved lower extremity may be noticeable; the patient may have difficulty sitting on the buttocks; and the patient may exhibit a splayed foot on the affected side.
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