Does your bum hurt? Does it hurt when you sit for long hours? Does it get so bad you need to take painkillers? You could be suffering from piriformis syndrome.
The piriformis muscle is a small muscle found deep within your buttocks area, its main function is to rotate the hip outward and stabilize the hip joint for support when walking. When this muscle is tight, it causes buttock or hip pain which is a tell-tale sign of a musculoskeletal condition called piriformis syndrome.
Signs and symptoms
Pain on either side of the butt when sitting for long or applying pressure on the affected side.
Functional hip movements like stair climbing, squatting, standing from a seat and walking are painful.
Pain at the beginning of movement that may get better with walking.
Numbness/loss of sensation on the thigh, calf or toes.
Burning pain on the thigh (especially on the back) and knee when seated.
Causes of piriformis syndrome
Direct trauma on the muscle (example from a fall)
Sustained compression when sitting for long hours without a break.
Shortening/tightening of the muscle in effort to adapt to wrong hip and pelvis biomechanics.
Overuse and repetitive hip movements, for example in cyclists.
Post-operative hip complication.
Physiotherapy diagnosis
A physiotherapist will be able to diagnose you by identifying the following.
The nature of your pain?
The relieving and provoking factors of the pain
The location of your pain, for instance does the pain go down the leg?
Your day-to-day activities, for example do you sit for long hours at work without a break?
Also, your physiotherapist will conduct manual diagnostic tests such as FAIR test, SLR, palpation of the piriformis or the lasegue’s test.
Treatment
Administration of NSAIDs and muscle relaxants to manage the pain.
Lifestyle modification involves identifying the provoking factors and eliminating them.
Physiotherapy.
Surgical approach- this is to be done only when non-surgical approaches were not fruitful.
Physiotherapy management.
It will be targeted to reduce pain, relieve muscle spasm and relieve pressure on the sciatic nerve. This entails;
Heat therapy coupled with electrical stimulation (TENS).
Stretching to release tight muscles.
Strengthening of the hip muscles.
Posture correction exercises and education.
Issuing home exercise programs and instructions. These include patients to avoid sitting for long hours, set timers at work to stand and stretch and doing the exercises daily. This prevents reoccurrence/worsening of the condition.
