General

Piriformis syndrome

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The the piriformis disorder is a disease that manifests in cases where the sciatic nerve gets squeezed or compressed. this causes inflammation of the muscle of the piriformis.

The muscle is extremely tiny and is situated within the hip. More specifically, it originates from the anterior part of the sacrum. It extends to the interior surface of the upper section of the femur. The piriformis’s job will be to support the hip, and permit the abduction and rotation. That is, the motion which moves the leg away from the body’s axis. Thus, the piriformis is a crucial stabilizer of the hip and the femur and, as a result, it can become a muscle. It frequently experiences overloads which can have consequences for the entire area of the pelvis as well as posture.

The primary reasons for piriformis syndrome are:

The primary causes of this disease aren’t entirely clear and there are many theories concerning the cause. The most well-known cause is the one of Kendall who proposed that the root of the issue was due to the direct or repeated trauma. One example of repeated trauma would be driving in a car, which makes the piriformis stay in tension and , consequently, the muscle loses its elasticity.

The piriformis muscle is situated between the pelvis and femur and is impacted by all adjustments to the articular and postural postures; it is the result that the muscle attempts to adjust to these changes through activating its trigger points.

 

Trigger points are places in the body that have more stiffness and density in the tissues. Therefore in reality, they function as the knots of a muscle fiber that is constantly contracting. To learn more, click here.*

Therefore, the piriformis syndrome can be attributed to mostly secondary causes. Primary causes are direct trauma that puts physical pressure placed on sciatic nerve for example:

technically incorrectly or in inappropriate shoes

anatomical abnormal bone, muscle, or nerve

Direct trauma and muscle injuries

excessive stress on the muscle that is caused by constant and continuous physical exercise

pelvis, and lower limb pain (e.g. bad position or leg length discordance)

being in a sitting position for long periods of period of time

Signs and symptoms of the piriformis syndrome

The most prominent symptoms of piriformis syndrome are discomfort in the gluteal region and is increased when you sit for longer than 15 minutes. The majority of sufferers complain of discomfort that begins in the buttock region and then spreads into the knee area or even the toes. Other symptoms that are typical include:

discomfort in the hip region that is felt as tingling or the sensation of numbness

pain on palpation

It hurts when you get out of the bed

The pain gets worse the moment you sit

The diagnosis of the syndrome of piriformis

Piriformis syndrome symptoms are like the symptomatology of sciatica. So much that it’s described to be “false sciatica”, so it is crucial to rule out other conditions like a herniated disk through a careful diagnostic differential.

The differential diagnosis involves identifying other pathologies with the same symptoms and in order to do this it is necessary for certain imaging tests to be carried out:

Clinical tests:

The Freiberg test is a way of stretching the muscles of the piriformis If their stretching causes pain, it can be said to mean that the test is positive.

The Pace and Nagle test involves the participant trying to spread their legs out by pushing the walls with their fingers so that an isometric contracture of the piriformis muscles is created. If the muscle will feel pain, and the test is positive.

The MRI scan as well as the CT scan

An even more thorough depth of study is possible through MRI that can reveal issues in bone and soft tissue structure. CT scans allow for the visualization of the structures within an anatomical model in three dimensions. However, it’s not recommended for patients who are the most radiation.

Electromyography

An effective test to determine the conductivity of nerves in the muscles is electromyography. This test is a way of assessing the functioning of the muscles and structures that comprise the nervous system as well as the muscles. It is an examination that makes use of electrochemical impulses produced by electrodes in order to determine the possibility of diseases of nerve system.

Treatment of the piriformis syndrome

The form of treatment to be administered varies based on

Symptomatology

The intensity of pain

The patient’s genital amenesis

In all cases it is recommended to treat yourself with conservative care. advised over surgery, and you can pick from:

Medications

The use of medicines is beneficial in the acute phase. This is due to the fact that anti-inflammatory medications reduce inflammation and ease pain. However, they don’t can cure inflammation, in fact , the medications are helpful to ease pain , but not to treat the source of the problem.

So osteopathic and physiotherapy therapies are the most effective treatments for piriformis, but it is important to remember that a lot of times, the piriformis could be suffering from other issues of the body like the lower the limbs.

Muscle massage

We have seen how trigger points get activated in patients suffering from piriformis, the massage of muscles has its goal to treat trigger points and reduce their contracture. After the trigger points have been disengaged, there will be a decrease in the piriformis, which will lead to an immediate improvement in the symptoms of pain.

 

Ischemic compression

Another method of trigger point decompression involves pressing a specific area so as to change blood pressure. Restoring a healthy state on the circulatory level can end the adhesions common to trigger points and normal tissue physiology.

Stretching

The process of stretching is comprised of gradually lengthening the muscles and retaining the final posture until your muscle is relaxed in order to restore normal physiological.

Laser Therapy

Laser therapy utilizes laser beams to affect cells. The effects of this therapy on cells are increase in metabolism of cells as well as healing of mitochondria (considered as the lung of cells) Thus, stimuliation of the mitochondria can lead to relief of symptoms and encourages the healing of tissues. However, the benefits of laser therapy don’t stop there; in fact, on top of the advantages already mentioned, laser therapy can be beneficial to:

  • Oedemas
  • lymphatic drainage
  • tissue oxygenation
  • Electrotherapy

Also known as TENS, electrotherapy is the most commonly used treatment in the field of physiotherapy. By using electrodes, the professional physiotherapist stimulates electrically the nerve fibers under the skin. This procedure is very effective for treating muscle and joint pain.

 

Tecar therapy

The efficacy of tecar therapy is greatly dependent on the selection of the treatment method and by other methods and equipment employed. It is, however, an electromedical device which, when coupled with the right therapy could bring many benefits.

Natural remedies

The piriformis disorder, if it doesn’t manifest in a persistent and aggressive manner, can be handled in an autonomous manner by implementing a few actions like:

  • Massages
  • Stretching
  • Ice packs
  • Deactivation of trigger points

 

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