Chronic Injuries 3: Sciatica and Piriformis Syndrome

Piriformis Syndrome Sydney PhysioWhat are Piriformis Syndrome and Sciatica?

The Piriformis is a small yet volatile muscle in the gluteal system which works to laterally rotate the leg. It attaches the head of the femur to the set of Sacral bones (Sacrum) at the base of the spine.

Piriformis Syndrome is sometimes catagorised as Sciatica – a neurological condition effecting the compression of the nerves in the sacral part of the spine. This compression can cause spasm in the piriformis muscle and a Sciatica diagnosis is correct.

However, as the piriformis muscle attaches into the femur and is supported by the strong fascia from the ITB, it can be put under strain when coupled with any of the symptoms discussed in this series of articles (ITB Syndrome, Shin Splints, Plantar Fasciitis). This shortening and tightening of the Piriformis can then in turn cause the sciatic nerve to be compressed and neurological discomfort to be present and it is sometimes diagnosed as sciatica; yet in this instance you would treat for Pirifomris Syndrome.

In both cases, pain is felt in the glute area, just below the iliac crest (hip bone) and often couples with shooting pain in the leg or back, or sharp pain when elevating or bending.

Treatment

To treat Piriformis syndrome you must first determine the cause and whether any other symptoms are present.Physiotherapy Stretches for Sciatica Sydney Physiotherapy

An effective treatment for all of persistent myo-fascial (muscle and connective tissue) problems, on one side of their body or both, is Myo-Fascial Release (MFR). MFR gently stretches and opens up the Fascia and tissues beneath, allowing greater range of movement and less congestion, scar tissues and crossed fibres in the tissues, increased lymphatic and circulatory flow to heal.

Sciatica treatment involves determining the cause for the nerve compression. Often Piriformis Syndrome treatment will in turn treat the Sciatica. Frequently, an experienced Sydney Physiotherapist will need to manipulate the joint to free the impingement of the nerve. Sometimes, a bulge or inflammation of the disc will cause the compression, in these instances, the work is gentle and gradual to create more space in the facet and reduce swelling.

Self-preventative treatments will include Pre-exercise heat (such as a shower or heat pack) followed by active stretching of warm tissues and home massage with hands, fists, foam rollers or spikey balls. A vibrating massage tool can be very effective at breaking down very tight tension in this area.

Post-exercise ice, elevation and static stretches including stretching of the glutes, quads and hamstrings. Should you be suffering from a chronic problem, or yours is in relation to an injury, then strapping or taping may be provided by your Physio whilst you are undergoing treatment, and then sometimes as an on-going method to prevent tissue pattern damage caused by old scar tissue.

The aim is to work at keeping the fibres open throughout your body to assure natural motion and health. I would also suggest Pilates to work on balance and posture as, when practised regularly,  this will stretch and strengthen the core and fundamental tissues essential for balance and strength and will put you in touch with the feeling of a straight and healthy you.