Causes of Sciatica – Piriformis Syndrome

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Sciatica caused by Piriformis Syndrome

Let us understand about Piriformis syndrome. To understand it you must be familiar with vital anatomic structures, the sciatic nerve and the Piriformis muscle.

The sciatic nerve is the largest among all the nerve in our body. It is a nerve bundle that starts from the spinal cord. Generally they occur from levels L4, L5, S1, S2, S3 and S4. However in some people it maybe higher at L2 or L3. The nerve is responsible for muscle strength and more importantly skin sensation in thighs, lower legs and feet.

Under the gluteus maximus muscle, Piriformis muscle is situated, whose main purpose is to rotate our leg outward. It is joined to one side of the tailbone or sacrum and inserts into hipbone or femur. The shape of this muscle may differ from people to people.

Let us now understand how Piriformis syndrome occurs. In some people it can be seen that the sciatic nerve passing below the Piriformis muscle and then branching into the legs. The nerve may branch out before the muscle. So during the stress, strain or injury the muscle may contract which squeezes the sciatic nerve. This gives pain in thighs, buttocks or lower legs. This is called as Piriformis syndrome.

Know if you are suffering from Piriformis syndrome

To know if your sciatica is due to Piriformis muscle, you can test that in five seconds. First you have to locate where your Piriformis muscle is located. This can be found by finding the part of the hip bone where one side of the leg sticks out. Now if you move your fingers three-four inches towards buttocks, which should be ideally the position of Piriformis muscle. Now firmly press the area using your thumb. If you feel pain only when pressing, you may have swollen Piriformis but not the syndrome. The reason for sciatica is other than this probably.  However, Piriformis syndrome is the reason for sciatica if you’re having localized pain and you are also experiencing tingling, numbness and sometimes pain radiating downward towards the leg.

How to get rid of Piriformis syndrome

The initial goal for treating Piriformis syndrome is to lessen the inflammation around the sciatic nerve and decrease the muscle contraction. This can be bought by various therapies like-stretching, heat, electrical simulation, deep massage etc. Stretching helps the muscle to keep relaxed and elongated and not clustered. If your Piriformis syndrome is recurring, unfortunately you may be among the 15% of the people who are inclined to this problem. It can also be an indication that the nerves are irritated due to disc bulging and simultaneously by Piriformis muscle. So, you may have to go for a double treatment for the case. i.e., for bulging disc as well as muscle treatment.

Why is the confusion?

Most sciatica cases will have tenderness and tightness near the buttocks muscle. Many general practitioners spend most of their time focusing on one area. Sometimes this may result in misdiagnosing the Piriformis tenderness and tightness with sciatica. When the cause of sciatica is due to Piriformis muscle, the pain can be felt on muscle palpation and sometimes a tight painful muscle.

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