Lower Back Pain
Why Your Piriformis Muscle Maybe The Culprit
If your GP were to frown and mention the Piriformis muscle as the possible cause of your back pain – you would just sit there clueless?
“The what?” you’d say. “The piriformis,” your doctor would reply – and – chances are – you’d still be none the wiser.
So What Is The Piriformis Muscle?
Piriformis. Yes it sounds like some kind of Mexican hot pepper sauce but it is – in fact – a muscle. If you’ve never heard of it before it’s because it’s not a show off.
Unlike the biceps and the abs, you’ll never catch the piriformis flexing itself in bathroom mirror selfies – so sadly, you’ll never see a #piriformis.
Instead, this muscle lives a quiet and happy life in the gluteal region of your body. Yes – it lives deep in your buttocks where it forms part of a team of six muscles called the Lateral Rotator Group.
Its name comes from the Latin piriformis which basically means ‘pear shaped’ and it was first named in the 16th century by a professor from the University of Padua in Italy named Adriaan van den Spiegel. Adriaan was quite the over-achiever. He also gave the first comprehensive description of malaria and dabbled in botany too so there’s a genus of around 60 species of flowering plants named after him as well.
But we digress…. back to the piriformis!
What Does The Piriformis Do?
As part of the Gang of Six Lateral Rotators, the piriformis muscle helps to stabilise the pelvis and laterally rotate the femur in the hip joint. This helps you balance, walk and extend your leg outwards to the side.
Unfortunately, these muscles are also the major culprits in lower back and leg pain. The piriformis muscle’s position in particular can cause it to become tight and compress the sciatic nerve.
How Does The Piriformis Create Sciatica?
The sciatic nerve is the big enchilada of the nervous system. It is largest nerve and runs from the lower back through the buttocks and down the legs. The nerve is located near the piriformis muscle but in 17 percent of the population the nerve actually goes through the muscle. When the muscle tightens therefore, it can put pressure on the nerve and that big enchilada will let you know.
The result is soreness in the buttocks and referring pain along the sciatic nerve. This referred pain is called ‘sciatica’ and often travels down the back of the thigh and / or into the lower back area.
Interestingly, Piriformis Syndrome can also occur for other reasons; for example it could happen due to external pressure such as repeatedly sitting on a wallet placed in a back pocket or – in rare cases – can be the result of a direct blow to the buttock area.
How Do You Know If The Piriformis Is Creating Your Back Pain?
Those who suffer from Piriformis Syndrome have symptoms that can include:
- Dull pain in the buttock
- Soreness down the back of the thigh, calf and foot (sciatica)
- Pain when walking up stairs or inclines
- Greater pain after prolonged sitting
- A reduced range of motion in the hip joint
Piriformis Syndrome is often diagnosed through a process of elimination. When other possible conditions have been ruled out, such as a lumbar disc herniation or sacroiliac joint dysfunction, then your GP will frown and turn her or his attention to Piriformis Syndrome.
Your medical history is reviewed; a physical examination is undertaken and possibly diagnostic tests, too.
How Do You Release The Piriformis
When it comes to Piriformis Syndrome, almost every treatment approach involves carefully and gradually stretching the piriformis muscle. Your GP may recommend Physical Therapy that will include Piriformis stretches and hamstring stretches and exercises too.
Massage is a valuable treatment strategy as well. Deep tissue massage does much to enhance healing and is often very successful in controlling the aches and relieving the pain caused by Piriformis Syndrome.
Soft-tissue massage to the gluteal and lumbosacral regions increases blood flow to the area, extends the soft tissue, reduces irritation of the sciatic nerve and decreases muscle spasm. Deep tissue massage or a remedial massage should always form part of your recovery process from Piriformis Syndrome.
If Piriformis Syndrome is diagnosed and treated early, the prognosis is usually good. Unfortunately a later diagnosis has a less favourable prognosis. Symptoms that have been present for a number of months may take several weeks of treatment to resolve. Thankfully however, only very rarely is surgery required.