Piriformis syndrome can be a source of that nagging electric-like pain shooting down your leg. More commonly referred to as sciatica, piriformis syndrome refers to the cause of sciatica symptoms. If you or someone you know is dealing with pain or numbness down the leg or in the buttock, read below to find out why this is happening and give the exercises provided a try to get rid of that pain!
**This is not medical advice. Please consult your medical provider for more information.
What is Piriformis Syndrome?
Anatomy
The piriformis muscle originates on the anterior aspect of the sacrum from S2-4, the periphery of the greater sciatic notch, and the sacrotuberous ligament. It inserts onto the superior and medial aspects of the greater trochanter of the femur. It adducts the hip when it is flexed and externally rotates the hip when it is extended.
This muscle is pivotal for lower body movement as it enables you to walk, shift, and balance. The proximity of the piriformis muscle to the sciatic nerve is crucial. Any irritation or swelling of the muscle can lead to compression of the sciatic nerve, manifesting as pain, tingling, or numbness in the buttock, along the back of the leg, and into the foot – hallmark symptoms of sciatica.
What Causes the Shooting Pain?
Given its role and location, it’s clear why the piriformis muscle can become a source of discomfort. Activities leading to muscle spasms or inflammation, such as prolonged sitting, intense exercise, or even minor injuries, have the potential to trigger piriformis syndrome. This explains why those affected often struggle with not just buttock pain but a gamut of symptoms that can significantly disrupt daily life. Understanding the anatomy and function of the piriformis muscle is thus key in both diagnosing and treating piriformis syndrome effectively.
While nerve-related symptoms come from the nerve, the cause of this syndrome is the piriformis muscle itself. When the muscle is tight, it can entrap the sciatic nerve. Nerves like movement and when they don’t move well, they get angry and cause symptoms like sharp, electric, shooting pains. By getting the nerve to move better, this will lessen the severity of the pain and can even get rid of it.
We also can’t overlook the influence of biomechanical issues, such as nerve compression from muscle imbalances, often stemming from poor posture or improper form during activities.
As you can see, there are many different elements that could disrupt the sciatic nerve and the piriformis muscle. The trick is to go after the cause of the pain, NOT the victim. In this case, the sciatic nerve is the victim. The cause is the piriformis muscle which is entrapping the nerve. On top of that, determining why the piriformis muscle is entrapping the sciatic nerve is the ultimate key! This is why a comprehensive approach in both diagnosis and treatment is essential when treating YOUR pain.
What Can I Do About Piriformis Syndrome?
Lifestyle Changes
Sitting for long periods of time can lead to excessively stiff muscles, including muscles of the hip. Desk workers and truck drivers are prone to developing symptoms due to the sedentary nature of the job. Taking frequent standing breaks can help with preventing hip musculature stiffness. Here are a few other mentionable options to try:
- taking short walks
- getting an adjustable standing desk
- performing resistance exercises while sitting
- trying out a walking pad
- frequently stretching the piriformis muscle (see below)
Physical Therapy (And Why it Works So Well for Piriformis Syndrome!)
Piriformis syndrome very commonly comes from muscular imbalances. A physical therapy assessment will analyze the way you move, checking where you may be lacking or compensating. This assessment will determine what muscles are weak, what tissues or joints might be tight, and look at compensations that are occurring that would be contributing to the issues with the piriformis muscle. These findings will determine exactly what needs to be worked on so you can feel confident that your most pressing issues are being addressed so the compression on the sciatic nerve from the piriformis is not only relieved, but will also ensure it doesn’t come back!
Piriformis Syndrome Exercises
Sciatic Nerve Glides (Supine and Seated)
SUPINE: Lie on your back and grab behind your thigh or knee of the affected side of your body. Extend your knee out straight while simultaneously pulling your toes towards your head. You should feel a pulling sensation through your leg, as if the nerve is gently being “flossed.” Relax the leg back to the starting position, performing 20 repetitions.
SEATED: Sit and extend your leg out straight while simultaneously pulling your toes towards your head. You should feel a pulling sensation through your leg. Relax the leg back to the starting position and perform 20 repetitions.
Figure 4 Stretch (Supine and Seated)
SUPINE: Lie on your back with your knees bent and cross the ankle of your affected side over the opposite knee. For example, if you have pain in your right leg, cross your right ankle over your left knee. Grab behind your left knee and pull your knee towards your chest. You should feel a stretch in your right buttock and sometimes into your thigh. Hold this stretch for up to 30 seconds and repeat.
SEATED: Sit and cross the ankle of your affected side over the opposite knee. For example, if you have pain in your right leg, cross your right ankle over your left knee. Lean forward and you should feel a stretch in your right buttock. If this stretch is aggressive, you can rock back and forth as if you are turning the stretch off and on. If you are able to hold the stretch, hold the position leaning forward for up to 30 seconds and repeat.
Piriformis Stretch (Supine and Seated)
SUPINE: Lie on your back and grab the knee of your affected side. Pull this knee to your opposite shoulder. For example, if you have pain in your right leg, grab your right knee and pull it towards your left shoulder. Hold this position for up to 30 seconds and repeat.
SEATED: Sit and cross the ankle of your affected side over the opposite knee. Grab the knee of your affected side and pull it towards your chest. You should feel a stretch in the buttock region. Hold this position for up to 30 seconds and repeat.
Other Articles Related to Sciatica
- 5 Best Exercises for a Pinched Nerve in the Back
- Pain From Your Back Down Your Leg? Sciatica Treatment Explained!
- Sciatica Symptoms? Try This and Feel Better
Are There Prevention Tips?
Preventing piriformis syndrome starts with understanding how daily habits influence muscle balance and nerve health. Firstly, prioritizing posture is paramount, both in motion and at rest. If your lifestyle is sedentary, adding in some additional movement is an easy place to start. Start with standing for 30 seconds every hour. You could take a short walk daily and slowly increase your time. There are many different ways to incorporate more movement in your day.
Did you know your sitting position could also be to blame? Are you someone who sits with their legs crossed for long periods of time? This could be a quick fix to prevent any future stiffness in your hips.
Ergonomic adjustments could also be helpful. If you have a sedentary job and you have the ability to utilize a standing desk, this could be a great way to switch between sitting and standing and still be able to get your work done without sacrificing your productivity!
Regular exercise can further assist with reducing the chances of the piriformis muscle getting tight from nonuse. Remembering to focus on both stretching and strengthening exercises of various muscles will help prevent the chances of overuse and muscle imbalances.
TL;DR
Piriformis syndrome occurs when excessive stiffness of the piriformis muscle entraps the sciatic nerve causing nerve-like symptoms in your buttock and down your leg. Here are five exercises to help mobilize the nerve and improve muscle length to help prevent the shooting pain from coming back.
A big thank you to @amaripr
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