Have you been experiencing leg pains and numbness in one side of your limbs? Well, one probable reason for its occurrence could be Piriformis syndrome. Piriformis syndrome is a neuromuscular condition that arises when the piriformis muscle compresses the sciatic nerves leading to unilateral or bilateral pain and tingling sensations from the buttocks to the affected foot.
The sciatic nerves normally pass underneath the piriformis muscles; however, up to 17% of individuals may have their sciatic nerves pass through the piriformis muscle leading to sciatica whenever the muscles become spastic.
Causes of Piriformis Syndrome
The most common cause of piriformis syndrome is the presence of anatomical changes or conditions involving the muscles and the nerves along the buttocks. It can also be due to strain to the muscles leading to spasms that may compress or irritate the sciatic nerves.
Sciatica may be caused by various conditions along the spine, such as herniated disc and spinal stenosis, but piriformis syndrome only involves the changes in the piriformis muscles. When there is an overuse injury in the area such as in the case of bicycling and rowing, the piriformis muscles may exert undue pressure on the sciatic nerves leading to sciatica symptoms.
Inactive gluteal muscles may also contribute to the condition because inactive gluteals allow the piriformis to be more enlarged or hypertrophic. As a result, the piriformis muscle may just surround the sciatic nerves. Inactive gluteals may be developed from sitting for prolonged periods of time.
Other causes of piriformis syndrome include decreased mobility, over pronation of the foot, and falling injuries causing spasms on the piriformis muscles.
How does Piriformis Syndrome Arise?
The presence of any trauma, injury or strain in the piriformis muscle may lead the muscle band to contract and shorten. As a result, the sciatic nerve that passes through it may be entrapped on the shortened and spastic piriformis muscles.
Symptoms of Piriformis Syndrome
Since the main effect of piriformis syndrome is the compression of the sciatic nerves by the piriformis muscle, sciatica symptoms often emerge. These symptoms may include:
- Pain in one leg starting from the buttocks to the foot; however, bilateral affectations can also be possible
- Numbness and tingling sensation in one limb or both
- Difficulty moving the leg
Most of the symptoms are unilateral, but the presence of a bilateral injury may lead to affectation of both lower limbs.
Diagnosis of Piriformis Syndrome
The diagnosis of the condition is often difficult; nonetheless, there are two ways by which the compression of the sciatic nerve by the piriformis muscle may be seen. The FAIR test, an electrophysiological diagnostic test, measures the electrical conduction from the sciatic nerves while the piriformis muscles are stretched over the sciatic nerve. Another test, magnetic resonance neurography, involves a more sophisticated MRI test showing the sciatic nerves clearly as well as any inflammation in the area.
Treatment for Piriformis Syndrome
Treatments for piriformis syndrome often employ supportive managements. Stretching exercises, massage, physical therapy, and strength training of the core muscle groups are the main treatment modalities for piriformis syndrome. Limitation of activities that may aggravate the condition such as bicycling, running, rowing and others is also employed. Furthermore, the presence of pain can be managed through the intake of anti-inflammatory drugs such as ibuprofen and muscle relaxants.
Piriformis syndrome can be difficult to detect from other causes of sciatica because of similar symptoms, but proper consultation may just help you identify the real cause of leg pains.