Piriformis Syndrome. Sciatica. I have had more calls in the last week with patients suffering from chronic gluteal pain, thus resulting in today's post. This diagnosis is so difficult. Many times it is misdiagnosed, sometimes forgotten, and sometimes self diagnosed. So here we go....
PIRIFORMIS MUSCLE AND THE SCIATIC NERVE
I thought we'd start with a little anatomy. The piriformis muscle is a pear-shaped muscle in the gluteal area that functions as a hip stabilizer as well as a strong external rotator of the hip. In the above diagram, you can see the shape of the muscle as well as its relation to the sciatic nerve. In most people, the sciatic nerve exits the pelvis beneath the muscle, in some it splits above the piriformis with one branch of the nerve passing directly through the muscle and it a small population, the entire nerve passes directly through the muscle.
The term 'piriformis syndrome' has been used to describe the condition in which spasm/tension in the muscle produces entrapment and irritation of the sciatic nerve. There are almost always biomechanical issues to deal with, ie. bow/knock knees, high or low arches of the feet, leg length discrepancies, pelvic issues, trauma, obesity , poor posture, etc. ) However, this pathological tightness is often the result of FASCIAL ADHESIONS and/or TENDINOSIS. The symptoms include but are not limited to deep pain in the hip, often associated with numbness/tingling down the leg. Now, for all you anatomy buffs out there, what else does this sound like???
Yes, a disc bulge/herniation, specifically at L5-S1! Now, let's say a lumbar spine MRI is ordered due to a patient's presentation of the above mentioned symptoms and a disc bulge/herniation is found. Subsequently, surgery is recommended. Couple problems here....#1: Most of us have some type of disc derangement, with a lot of us being asymptomatic, or not presenting with any symptoms at all. #2: MRI's are known to give false positives, meaning that even though there is a positive finding, this DOES NOT mean this is the cause of the problem. So, surgery is performed, and there is absolutely NO relief of symptoms. Not good.
So, proper diagnosis is extremely important, followed by the correct treatment protocol. Here at Total Health Solutions, we have had great success in the treatment and prevention of 'piriformis syndrome'. As mentioned above due to this diagnosis being often a result of fascial adhesions and tendinosis, we use a technique know as IASTM, Instrument Assisted Soft Tissue Mobilization.
This technique utilizes a set of tools to break up scar tissue at an injury site to trigger an inflammatory response. The inflammation leads to the absorption of scar tissue and repair of the injured site. Combined with the proper rehabilitation, the body restores normal structure and function. The effects of IASTM include pain relief, increased flexibility, increased strength, enhanced recovery, and in most cases complete resolution of symptoms.
Refer to our testimonial page on our website, for the incredible success stories of this diagnosis. Please contact our offices if you think you may be suffering from this condition.
TAKE RESPONSIBILITY FOR YOUR HEALTH TODAY.
Dr. Courtney Conley
Chiropractor Golden, CO
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