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Q&A with Australian Health Practitioners
What can be done for piriformis syndrome?
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I have been diagnosed by my doctor with piriformis syndrome. He just said rest and it will get better. Is there anything that can be done to help? It's been 6 weeks now and still gets bad towards the end of the day. -
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Dr Ryan Hislop
Chiropractor
Ryan Hislop is the Clinical Director at the Orange Chiropractic Health and Wellness Centre. As an experienced and evidence-based diagnostician, Ryan works largely by medical … View Profile
If the diagnosis is correct, true piriformis syndrome involves compression of the sciatic nerve by the piriformis muscle (muscle that externally rotates the hip).
Often, direct treatments that your health care provider may offer are postisometric relaxation techniques (a specific type of stretch), myofascial release techniques. Physical therapy pain modalities such as TENS and interferential. You may find that heat may help to relax the muscle.
In rare cases, injection of the piriformis trigger point may be needed.
It is important to be assessed by someone trained specifically in musculoskeletal diagnosis such as your local chiropractor, physiotherapist or osteopath. Diagnosis is critical in a case such as this, as if the therapeutic intervention is aimed at the wrong componenet, little progress will be made.
In my clinic, we often look at the reason why the piriformis syndrom occured. Was is a repetitive strain mechanism, weakness of surrounding musculature that has made this area prone to injury and overuse, assymetry through weightbearing etc. This often results in a faster recovery and a decreased liklihood of recurrence.
Hope this helps,
Ryan
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Dr Danny Diab
Chiropractor
Dr Danny Diab is situated at Proactive Spine & Sports Medicine in Narellan NSW. His clinical interests extend far beyond the traditional neck and back … View Profile
Piriformis syndrome is a condition that involves irritation or compression of the Sciatic nerve by a muscle called the piriformis. The symptoms may include pain/tingling/numbness into the buttock and/or the thigh and lower leg (distribution of the Sciatic nerve).
Treatment options for piriformis syndrome include muscle release techniques, stretching and dry needling. The use of a foam roller or tennis ball may be effective to help release the muscle. Biomechanical assessment of the pelvis and lower limb is important to determine a cause for your injury. The condition will rarely resolve itself if the cause is not addressed (which is what you have found over the last 6 weeks). Once this is determined, treatment may involve joint manipulation/mobilization, tailored exercises to address muscular imbalances and modification of your activities.
It is important to note that the symptoms of piriformis syndrome often mimic other conditions eg. Lumbar (low back) Intervertebral Disc injury. This is why a complete orthopaedic and neurological examination by a qualified chiropractor, osteopath or physiotherapist is recommended to determine the exact cause of your pain and implement a specific treatment plan for your condition.
Danny Diab (Narellan Chiropractor)
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Brett Rawlings
Acupuncturist, Myotherapist
I’m an Acupuncturist, Credentialed McKenzie Method Therapist and Clinical Myotherapist with 20 years clinical experience treating musculoskeletal pain and dysfunction.10 years ago I made the … View Profile
It’s important to differentiate between piriformis trigger point activity or knots and piriformis syndrome. The syndrome, as others have pointed out, involves compression of the sciatic nerve as it passes through or near the piriformis muscle and is associated with neurological symptoms.
Piriformis trigger points DO NOT cause neurological symptoms. They give rise to referred pain over the sacroiliac joint region, hip or greater trochanter and possibly posterior thigh.
If you have neurological symptoms such as; numbness, tingling, shooting pain, burning, loss of sensation or weakness in the leg or foot then it could be piriformis syndrome, however, it is essential that your lumbar spine be eliminated as the cause! Not saying your GP is incorrect but piriformis syndrome is RARE.
Both piriformis trigger points and piriformis syndrome result from simple muscle spasm/trigger point activity and will respond rapidly, 1 -3 treatments, to appropriate dry needling or acupuncture.
I’m very interested that you say “it gets bad towards the end of the day”. Would love to know what your day involves! If it’s sitting, you most probably need some advice on ergonomics in combination with appropriate treatment.
I suggest you visit the official www.mckenziemdt.org.au and find a qualified McKenzie Method practitioner to help you with your issue.
Good luck!
Brett Rawlings
Cred. McKenzie Method
Doctor of Acupuncture
Clinical Myotherapist
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Dr Kal Ientile
Acupuncturist
Kal Ientile is a Doctor of Traditional Chinese Medicine and a Registered Acupuncturist. His key focus is in pain management and musculoskeletal disorders. Kal received … View Profile
A very well worded differentiation between piriformis trigger points and piriformis syndrome.
I agree that most cases will will resolve in a short course of treatment with accurate trigger point release needling.
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