Piriformis syndrome refers to a neuromuscular disorder that occurs when the piriformis muscle compresses the sciatic nerve.
The piriformis muscle is a band-like and flat muscle that is located in the butt near the top of the hip joint. This muscle is crucial for lower body movement as it provides stability to the hip joint and lifts and rotates the thigh away from the body.
This allows a person to walk, shift their weight from one foot to another, and maintain balance. It is also vital to performing sports activities involving lifting and rotating the thighs. In fact, it is essential for almost every movement of the legs and hips.
The sciatic nerve is a long, thick nerve in the body. It extends alongside or goes through the piriformis muscle, extends down the back of the leg, and eventually branches off into smaller nerves that end in the feet. A spasm of the piriformis muscle may cause nerve compression.
Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides orthopedic surgery to patients in Los Angeles, Century City, CA, and surrounding locations.
The piriformis muscle can compress or shorten the sciatic nerve underneath the muscle when it shortens or spasms because of trauma or overuse. In general, these types of conditions are known as nerve entrapment or as entrapment neuropathies.
The specific condition called piriformis syndrome involves sciatica symptoms that do not originate from spinal roots and/or spinal disc compression but occur due to the involvement of the overlying piriformis muscle.
In 17 percent of an assumed normal population, the sciatic nerve goes through the piriformis muscle, instead of passing beneath it. But in patients receiving surgery for suspected piriformis syndrome, such an anomaly was detected only 16.2 percent of the time. This creates doubt about the relevance of the anomaly as a contributing factor in piriformis syndrome.
According to some researchers, the relevance of this relationship in the etiology of the syndrome is not high. However, MRI findings indicate that hypertrophy (unusual largeness), as well as atrophy (unusually smallness) of the piriformis muscle, is related to the supposed condition.
Some theories hypothesize that individuals who exercise routinely by bicycling, running, and other forward moving activities may be more prone to developing piriformis syndrome if they do not perform strengthening exercises and lateral stretching.
But it is also likely that such individuals actually have small herniations in a spinal disc which compress the sciatic nerve and lead to a piriformis spasm secondarily.
There is scant evidence indicating a specific relationship between the strength or weakness of particular hip muscles and sciatic pain centered on the piriformis muscle. Additionally, this sports-related explanation is not useful in understanding the piriformis syndrome in people who are not particularly physically active (which is frequently the case).
A piriformis muscle spasm can result in the impingement of the sciatic nerve as well as the pudendal nerve. The pudendal nerve controls the muscles of the bladder and bowels. Pudendal nerve entrapment symptoms include numbness and tingling in the saddle areas and groin. It can also cause urinary and fecal incontinence.
Piriformis syndrome may also be related to direct injury to the piriformis muscle, such as from a knife wound or in a fall.
Board certified orthopedic surgeon Dr. Tigran Garabekyan receives patients from Los Angeles, Century City, CA, and nearby areas for orthopedic surgery.
Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:
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