He piriformis syndrome or piriformis syndrome It consists of a pathology caused by entrapment by compression or irritation of the sciatic nerve as it passes through the gluteal region, generating pain radiating to the hip or leg.
The piriformis muscle, located in the pelvic trochanteric area (from the greater trochanter of the femur to the anterior surface of the sacrum) acts as the main external rotator of the hip and abductor when the hip is flexed, in addition to providing it with stability.
Symptoms of piriformis muscle syndrome
- Pain in the deep gluteal area.
- Discomfort when walking, sitting or doing physical activities.
- Paresthesia (tingling, prickling, numbness or burning in the buttocks and legs).
- Radiated pain.
- Loss of strength.
How can we differentiate piriformis syndrome from other pathologies?
Piriformis syndrome requires a thorough evaluation, since it presents symptoms very similar to other lesions and, therefore, can lead to an incorrect diagnosis. Pathologies that could lead to confusion with compartment syndrome are:
- Lumbar radiculopathy (sciatica): Since this is a pathology of lumbar origin (disc herniation, stenosis, spondylolisthesis, etc.), the patient usually has pain in the lower back. It consists of irritation, compression or inflammation of the nerve root. In this case, the treatment of choice will consist of lumbar decompression with vertebral traction or spinal stabilization exercises.
- Trochanteric bursitis: It is caused by inflammation of the trochanteric bursa. The patient presents pain on the lateral side of the hip, which may radiate to the thigh, especially when walking, climbing stairs or lying on the affected side. The pain is more superficial when pressing on the greater trochanter. Pain on internal or external rotation of the hip is more related to piriformis syndrome than to bursitis.
- Iliotibial band syndrome: Pain on the side of the knee or hip, which worsens with physical activity. In this blog we explain this injury.
- Hip osteoarthritis: This is a degeneration of the hip joint cartilage, which is common in athletes due to overuse, older people, or overweight people. It causes deep pain in the groin, hip, or buttock, which increases when standing for long periods of time or walking. There is a progressive loss of mobility, especially in internal rotation and abduction.
- Lateral femoral cutaneous nerve entrapment syndrome (meralgia paresthetica): It is caused by compression of the lateral femoral cutaneous nerve, which innervates the lateral part of the thigh. The patient experiences a tingling, burning or numbness sensation on the anterolateral side of the thigh (the pain does not follow the path of the sciatic nerve, and does not present symptoms in the buttocks or leg).
- Sacroiliitis: Inflammation of one or both sacroiliac joints. The patient feels pain in the lumbar area or buttocks that may radiate to the legs. It is usually associated with stiffness in these joints and may increase in intensity with sudden movements or after standing for a long time.
Physiotherapy techniques to reduce pain caused by piriformis syndrome
Physiotherapy and therapeutic exercise are two very effective tools in the treatment of pain. In the case of sciatic nerve involvement at the level of the gluteal muscles, we can use a series of techniques to address this pathology:
- Manual therapy: Massage of the buttocks and pelvic trochanteric muscles, as well as fascial manipulation of the tissue near the nerve can release tension in the affected area.
- Neurodynamics: Mobilization of peripheral nervous tissue to promote sliding of the sciatic nerve and improve its functionality.
- Percutaneous neuromodulation: Through a current applied to a needle on the affected nerves, changes are generated in neuromotor recruitment and in the perception of pain.
- Diathermy: Through the application of high-frequency current, which generates heat on deep planes, the regeneration of damaged tissue is enhanced.
- Stretching of the gluteal and posterior leg muscles: Stretching these muscles can reduce pain and improve mobility. Below are some videos for stretching the piriformis muscle.
Physiotherapy in Alcalá de Henares for the treatment of piriformis syndrome
At our Evolution Advanced Physiotherapy Clinic we treat neuromuscular conditions such as piriformis syndrome.
After carrying out a physiotherapy diagnosis that helps us differentiate this pathology from those previously mentioned, we use cutting-edge treatment techniques and advanced technology to achieve a successful recovery from the injury.
Our approach is based on reducing pain, inflammation and irritation or nerve compression of the affected structures.
Recover your well-being and say goodbye to pain! At our physiotherapy clinic in Alcalá de Henares we have a team of health professionals specialized in the treatment of piriformis syndrome. Schedule your appointment with us and we will help you!
