Piriformis syndrome

The piriformis syndrome is a compression of the sciatic nerve ( sciatic nerve ) during passage through the foramen infrapiriforme between the pelvic bone and the piriformis muscle.

Causes

The piriformis syndrome usually occurs after a trauma and is associated with severe pain in the buttock region. However, it is not yet certain that these complaints actually go out of a compression of parts of the sciatic nerve.

The piriformis syndrome is often confused with a lumbar disc problem, because the symptoms that appear when Piriformis syndrome, a root irritation of the sciatic nerve are similar.

The Pirifomis syndrome often applies when there is no clear cause can be diagnosed for " sciatica ". The sciatic nerve leaves the pelvis at the level of the buttocks, runs on the back of the thigh and sends its branches, finally, to the toes. At the exit point of the nerve passes together and immediately below the piriformis muscle by a bony opening of the basin. The actual cause is the inadequate extension capability ( either by tension or shortening ) of the muscle, as tends the piriformis muscle with time. The muscle mass remains the same, the muscle becomes thicker. This increased space requirement is charged to the sciatic nerve. It comes to the irritation. The cause of this behavior is not yet scientifically clearly understood.

Possible causes are:

• Long one-sided seats ( computer work, driving a car)
• Wallet in the back pocket
• Overexertion (especially stooped posture )
• Lifting heavy objects from the opponent out

Diagnostics

One way to differentiate the piriformis syndrome from other causes, provide muscle testing. The piriformis muscle is stretched during hip lateral rotator and as with the hip flexed as an abductor. If these two movements performed against resistance to pain provocation, this indicates a piriformis syndrome.

The test of the external rotation can be examined in the supine position with over the edge hanging down lower legs. The examiner then places his hands against the two inner ankle and asking the patient to squeeze their feet against this resistance inside. Here there is an external rotation and contraction of the external rotators of the hips, which are painful in the case of piriformis syndrome.

The abduction is tested in a sitting position. The examiner places his hands on the outside of the knee and the patient presses his knees against this resistance outwardly away.

Besides, a Dehntest provoke pain. The strain can be as passive adduction of the leg while sitting or as passive internal rotation of the thigh by moving the supine on the edge hanging down the leg inward.

Treatment

For treatment massage, trigger point treatment and exercise therapy ( stretching exercises ) are used.