Piriformis Syndrome and Sciatica can be very painful conditions often described as a literal pain in the butt. Additionally, the pain can occur in the hip, down the back of the leg to the side of the foot and anywhere in between. These two conditions are similar in that they can be caused by compressing (irritation of) the sciatic nerve and its out-branching nerves, which can be caused by the piriformis muscle being impaired (going into a spasm, being too tight or overcompensating for other hip and low back muscles becoming weakened). 1
This can be due to something as simple as a muscle spasm or trauma that can occur from excessive sitting in an improper manner, sitting on a surface that is too hard or through overuse such as walking/running more than our body is used to or repetitive lifting/carrying etc. 2 It can also occur over time with improper walking/running body mechanics, impaired circulation (heart or blood pressure problems), arthritic conditions or through direct trauma such as a fall or car accident. 2 & 3
While sciatic pain can be painful enough to warrant emergency room visits, fortunately there are solutions to addressing the pain. There is ample evidence to suggest that physical therapy can benefit most people with sciatica type pain through a combination of soft tissue therapy, exercise, modalities and modification of activity and body mechanics, treatment can often resolve issues and provide education on how to lower the likelihood of a relapse in pain. 3, 4, 5 & 6 While physical therapy treats all patients on a case to case basis by finding what is causing pain for each person, generally it will involve relaxing overstrained muscles, strengthening muscles that aren’t doing enough to stabilize the joints, improving posture/walking mechanics and providing education as to how to improve symptoms as quickly as possible in hopes of resolving pain and ensuring it does not return. If you are suffering from pain in your back, hip or down your leg, talk to your physician about physical therapy as soon as possible as the faster you seek help once your pain starts, the better the chance of speedy recovery.
1. Lori AB, McClain RL, Coleman MK, and Thomas PP. Diagnosis and management of piriformis syndrome: an osteopathic approach. The Journal of the American Osteopathic Association.November 2008; 108: 657-64.
2. Piriformis Syndrome. Retrieved from Physiopedia on November 11, 2016 at http://www.physio-pedia.com/Piriformis_Syndrome.
3. Tonley JC, Yun SM, Kochevar RJ, Dye, JA, Farrokhi S and Powers CM. Treatment of an individual with piriformis syndrome focusing on hip muscle strengthening and movement reeducation: a case report. Journal of Orthopaedic & Sports Physical Therapy.Feb 2010; 40(2): 103-111.
4. Fishman LM, Dombi GW, Michaelsen C, Ringel S, Rozbruch J, Rosner B and Weber C. Piriformis syndrome: diagnosis, treatment, and outcome—a 10-year study. Archives of Physical Medicine and Rehabilitation. 2002 March;83(3): 295-301.
5. Fishman LM, Anderson C and Rosner B. Botox and physical therapy in the treatment of piriformis syndrome. American Journal of Physical Medicine and Rehabilitation. 2002 December;81(12): 936-42.
6. Cherkin DC, Sherman KJ, Kahn J, Wellman R, Cook AJ, Johnson E, Erro J, Delaney K and Deyo RA. A comparison of the effects of 2 types of massage and usual care on chronic low back pain: a randomized, controlled trial. Annals of Internal Medicine. 2011 July 5;155(1):1-9.