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Piriformis muscle syndrome is an uncommon condition when there is a neuromuscular disorder due to which the sciatic nerve gets compressed or gets disturbed due to piriformis muscle. These condition leads to pain, numbness and tingling sensation in your buttocks and along with the way of sciatic nerve descending the lower thigh and into your leg. The compression of nerve can be happen due to spasm of the piriformis muscle.

The Piriformis muscle is a flat, small and band like muscle which is located in the buttock, deeply behind the gluteus maximus. It begins from lower spine and then merges to the upper surface of the thighbone (femur). It is a vital muscle for the movement in lower body as it stabilizes the hip joint, also rotates and lifts the thigh away from our body which enables us to shift our weight to another, walk and maintain balance.

According to an estimate 30 to 45% of people of 18 to 55 years of age have lower back pain which also includes piriformis muscle syndrome. Also, patients are mostly females then males.

Due to gluteal spasm or trauma, commonly piriformis syndrome is secondary to inflammation. This inflammatory process affects on the sciatic nerve is chemical instead of mechanical.


The following are the most commonly symptoms patients describe about:-

  • An acute tenderness and pain can be observed by patient in the buttock.
  • A sciatica kind of pain down to the back of the calf, thigh and foot can be felt.
  • Walking, climbing upstairs becomes painful.
  • After a prolonged sitting, an increase in the pain.
  • Range of motion reduces at the hip joint.
  • Pain can be felt mostly on the one side, sometimes on both the sides.
  • Weakness in the legs, changes in the sensation are found rarely.


The following are the reasons responsible for the piriformis muscle syndrome:-

  • Due to any injury or spasm, muscle gets tightened which causes piriformis syndrome.
  • The piriformis muscle gets swell out due to an injury.
  • Due to bleeding in the area of piriformis muscle.
  • Due to chronic pelvic inflammatory diseases


There are some tests and physical examination of the patient which is very much necessary for a physiotherapist to start your treatment-


  • One of the vital factor during physical examination is to differentiates sciatic pain from piriformis syndrome is the absence of neurologic deficit in piriformis muscle syndrome.
  • The Lasegue sign is used to diagnose the whether the pain is present in the vicinity of the greater sciatic notch during extension of the knee with the hip flexed to 90%. It is a range of motion test.
  • The Freiberg test is another test in which your doctor will ask you to lay back on your back before lifting and rotating your leg. If the pain occurs in buttocks, test can be said as positive.

  • MRI- The magnetic resonance neurography is an imaging technique which can show the presence of irritation in the sciatic nerve at the stage of the sciatic notch where the nerve passes under the piriformis muscle.
  • EMG- Electromyography can be useful to differentiate piriformis muscle disorder syndrome from other possible problems. This test incorporates active maneuvers which may have a high specificity and sensitivity.
  • X-Ray- An x-ray can be used to exclude conditions other than to detect the sciatic nerve irritation at the piriformis muscle. These conditions can cause similar symptoms to piriformis syndrome.


The following non surgical treatment can be recommended by your physiotherapist to reduce the pain:-

  • In the beginning of pain, one can use ice pack on the painful area repeatedly. It will be helpful to combine a gentle massage with ice.
  • Also, the hot water bags can be a better alternative. Using the heating pad on the painful area can provide relief from pain and will help to cure soon
  • To decrease inflammation in the affected area, some non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen or naproxen can be used but only after the recommendation from your physiotherapist.


The following physiotherapy treatment can be given to the patient by your physiotherapist in order to heal the piriformis syndrome-

  • Fire Hydrant In-Out
  • Bodyweight Jump Squats
  • Lateral Band Walks
  • Glutes Roll
  • Self-Trigger Point therapy
  • Pigeon pose
  • Low Lunge
  • Frog pose
  • Foam Roll To Hip Rotator
  • Reclining Cow’s Face Pose
  • Reclined Pigeon With Prep
  • Simple Seated Twist
  • Standing Twist wsx
  • DEEP MASSAGE:- To enhance healing by increasing blood flow to the area and to decrease muscle spasm a deep massage by your physiotherapist can be given to the patient.
  • TENS:- The transcutaneous electrical nerve stimulation unit can be helpful to block pain and reduce muscle spasm related to piriformis muscle syndrome. It can be applied in the affected area by your physiotherapist.
  • Ultrasound:- An increment in the local blood flow can be used to help reduce swelling and chronic inflammation with the help of an ultrasound. The muscle ligament injuries can benefit from therapeutic ultrasound.

Dr Sunil tank

Physiopoint jaipur

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