Who's at Risk for Piriformis Syndrome?

Effective treatment for chronic pain relies heavily on accurately diagnosing what’s causing your discomfort. That’s certainly the case with piriformis syndrome versus sciatica. 

Piriformis syndrome originates in a buttock muscle. Sciatica stems from problems with the bony structure of your lower spine.

Our team at Colorado Clinic, with offices in Colorado Springs and Greeley, Colorado, specializes in treating chronic pain conditions without surgery. 

Our expertise includes advanced therapies and interventions for cervical, thoracic, and lumbar spine disorders and numerous other conditions causing pain and disability, including piriformis syndrome.

What’s the difference between piriformis syndrome and sciatica?

Both the piriformis muscle and sciatic nerve are involved in piriformis syndrome. The piriformis is a narrow, triangular, flat muscle that runs diagonally from the lower spine, across the buttocks, to the upper femur (thigh).

Nerve roots exiting the spinal column in the lower back and sacrum combine to form the sciatic nerve, which runs under the piriformis muscle as it travels through the buttocks and down the backs of both legs.

The piriformis muscles, one per side, are engaged in essentially every movement of your lower body. Standing, walking, climbing stairs, running, or simply shifting your weight from side to side when sitting requires help from the piriformis. 

The sciatic nerve, the largest in the body, controls movement and sensation in the buttocks, legs, and feet.

Herniated discs, an injury, or degenerative changes in the spine can compress sciatic nerve roots where they exit the backbone, causing pain, tingling, numbness, and other symptoms commonly called sciatica.

On the other hand, piriformis syndrome occurs when swelling or inflammation of the muscle causes it to press on the sciatic nerve, resulting in nerve irritation that can cause:

• Aching, burning, or shooting pain in the buttocks or legs
• Numbness and tingling in the buttocks
• Pain with sitting that worsens the longer you sit
• Muscle tenderness in the buttocks
• Pain in the buttocks and legs that increases with walking, running, or climbing stairs

Piriformis syndrome can make it challenging to sit at a desk, drive a car, or perform other routine activities.

Who’s at risk for piriformis syndrome?

Piriformis syndrome may be related to a variety of activities that increase the risk of muscle swelling or spasms, including:

• Excessive stair climbing, running, or other exercise leading to overuse injury
• Prolonged physical inactivity (e.g., sitting at work) tightening and inflaming the piriformis
• Inadequate warmup before or stretching after strenuous exercise
• An injury suffered during a fall, car accident, or other trauma
• Adhesions (scarring) related to piriformis injury
• Overtraining for a marathon or other competitive event

You may also have primary piriformis syndrome, which occurs when the sciatic nerve runs unusually close to the piriformis, increasing your risk of pain and other symptoms.

How is piriformis syndrome treated?

Treatment at Colorado Clinic always starts with a thorough evaluation and accurate diagnosis that may require imaging studies to rule out spinal issues.

Your individualized treatment strategy may include:

• Rest
• Activity modification
• Home exercises
• Medications to relax muscles or reduce inflammation
• Guided physical therapy to stretch and strengthen the piriformis
• Steroid injections to reduce inflammation and pain
• Botox® injections to decrease muscle contractions

Your Colorado Clinic provider may also recommend various treatments, such as nerve blocks, to eliminate pain as you undergo physical rehab, modify your activities, or otherwise address the underlying cause of piriformis syndrome.

Schedule an evaluation at Colorado Clinic today for definitive nonsurgical treatment you can rely on to effectively address chronic pain. Call the office or request an appointment online.