Video Instruction on Testing for Piriformis Syndrome
This video shows several different tests to find out if a patient is suffering from Piriformis Syndrome. It is explained in enough detail that a coach or other person with some knowledge of the body couldd undertake this test.
Difficulties With Diagnosis
Piriformis syndrome is a peripheral neuritis of the sciatic nerve caused by an abnormal condition of the piriformis muscle.1 It frequently goes unrecognized or is misdiagnosed because it is confused with other problems which cause similar symptoms.
The ability to recognize piriformis syndrome requires an understanding of the structure and function of the piriformis muscle and its relationship to the sciatic nerve.
An explanation of this can be found in the following video which explains about sciatica and the relation of piriformis syndrome to sciatic pain.
More about the Piriformis
The piriformis muscle acts as an external rotator, abductor, and flexor of the hip. It provides postural stability during walking and standing,
The piriformis muscle originates at the anterior surface of the sacrum, at the level of vertebrae S2 through S4, near to the sacroiliac joint capsule. The piriformis muscle is innervated by spinal nerves S1 and S2—and occasionally also by L5.
In much of the population, the sciatic nerve exits the greater sciatic foramen deep along the inferior surface of the piriformis muscle. In over 20 percent of people the sciatic nerve pierces the piriformis muscle, pierces and/or splits the piriformis muscle which predisposes those affected to piriformis syndrome.
Some symptoms of the syndrome may be the result of inflammation caused by the muscular compression of small nerves and vessels.
Symptoms of Periformis Syndrome
The most common symptom is increasing pain after sitting for longer than 15 to 20 minutes. Symptoms, which may be sudden or have a gradual onset, and are caused by the spasm of the piriformis muscle and/or the compression of the sciatic nerve. Patients may complain of difficulty walking and of pain with internal rotation, for example when sitting cross-legged.
When the body tries to compensate for the problems with the piriformis muscle cervical, thoracac and lumbosacral pain may result as well as gastrointestinal disorders and headache.
Clinical signs of piriformis syndrome include tenderness during palpation, in the region of the muscle itself, including pain that may radiate to the knee and in the sacroiliac joint.
Some patients have a palpable “sausage-shaped” mass in the buttock caused by contraction of the piriformis muscle.
Exercises to treat Permformis Syndrome
Follow the link below to find some stretches and strengthening exercises to bring lasting relief to Piriformis Snydrome. You will probably have to do these exercises regularly on a permanent basis to avoid pain in the future.
Main Page on Piriformis Syndrome
(Sources: Diagnosis and Management of Piriformis Syndrome: An Osteopathic Approach by Lori A. Boyajian-O'Neill, DO; Rance L. McClain, DO; Michele K. Coleman, DO; Pamela P. Thomas, PhD; The Journal of the American Osteopathic Association)