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Treatment. Piriformis Syndrome

By Editorial Team (Y)
December 29, 2021

Piriformis Syndrome treatment

Piriformis Syndrome treatment often begins with non-surgical treatment, including Piriformis Syndrome medications and physical therapy. In cases that are not severe, a physician may monitor the patient’s symptoms to see if they improve. In more severe cases, surgery may be required.

Piriformis Syndrome medications

Such Piriformis Syndrome medications as non-steroidal anti-inflammatory drugs (NSAIDs), including naproxen and ibuprofen, are often used to decrease the inflammation and pain caused by nerve irritation. Acetaminophen will help relieve pain in many cases of Piriformis Syndrome, but it will not treat the inflammation.

If the Piriformis Syndrome treatment is ineffective in relieving the pain caused by the condition, your doctor may recommend injections of a local anesthetic. Medication such as lidocaine help to relax the muscle and decrease the irritation of the sciatic nerve. Other Piriformis Syndrome medications such as cortisone are sometimes combined with an anesthetic to relieve the inflammation caused by the condition.

Piriformis Syndrome treatment can also be done nonsurgically with botulism injection therapy. This is used to temporarily paralyze the muscle, relaxing it and taking pressure off the sciatic nerve. The effect of these injections on Piriformis Syndrome only lasts a few months. During that time, a program of stretching can be used, which will provide a more permanent solution. By the time the effects of the injection have worn off, the muscles are no longer producing symptoms of Piriformis Syndrome.

Physical Therapy

Most doctors refer patients with Piriformis Syndrome to physical therapy. A skilled therapist will evaluate your condition, including the condition of your hip and sacroiliac joints and your low back. Typical physical therapy for Piriformis Syndrome treatment may include:

  • Heat applications: Heat helps the muscles relax, which eases pain and spasms. Hot packs may be placed over the muscles of your buttocks, relieving the pain of Piriformis Syndrome.
  • Ultrasound: This therapy uses sound waves at a high frequency, directed through the skin to produce deep heating to the muscles. Deep heating prepares the muscles for stretching and frequently relaxes tight and tense muscles due to Piriformis Syndrome.
  • Hands-on treatments: These may include deep tissue massage and soft-tissue mobilization. The therapist may help position your leg and hip in such a way that relaxes nerve signals and reduces Piriformis Syndrome pain.
  • Stretching: Stretching for Piriformis Syndrome is usually attempted after applying heat and hands-on treatment. You will be positioned in ways that provide a good stretch to the piriformis muscle. Your therapist will also teach you ways to stretch at home. It is important to follow your program at home, being cautious and gentle as you stretch. Recovery from Piriformis Syndrome often depends on your compliance with your exercise program.

As your symptoms begin to improve, your therapist will likely increase your exercises to include training in posture, general conditioning exercises, and a muscle-strengthening program to help prevent future episodes of Piriformis Syndrome and serve as Piriformis Syndrome treatment.

Piriformis Syndrome surgery

Piriformis Syndrome surgery is usually considered only as a last resort for disease. Two procedures may be used. In the first, the piriformis muscle is cut where it connects to the hip bone. The other Piriformis Syndrome surgery involves cutting through the piriformis muscle to relieve pressure on the sciatic nerve in order to relieve symptoms of the condition. These are both typically outpatient procedures and Piriformis Syndrome treatment and may be performed using spinal or general anesthesia.

After surgery

Full recovery following Piriformis Syndrome surgery can take several months. Therefore, your surgeon will probably recommend physical therapy as Piriformis Syndrome treatment for the first several weeks. During physical therapy following Piriformis Syndrome surgery, your therapist may start with methods to control muscle spasms and pain such as massage, ultrasound, electrical stimulation, and applications of ice or heat.

As you continue to heal from Piriformis Syndrome, you will start learning how to regain your strength and mobility without injuring the healing area. As you continue to heal after surgery for Piriformis Syndrome, your therapist will challenge you to do more difficult exercises. The goal of therapy and Piriformis Syndrome treatment is to completely recover from Piriformis Syndrome, advancing in strength and functioning.

Eventually, you will be able to resume the activities you enjoy participating in. Your therapist will teach you how to safely participate in normal daily activities and provide guidance on what activities may be best to avoid to prevent recurrence of Piriformis Syndrome.

Pathological changes

The spinal nerves in your lower back exit the spine and join together to form your sciatic nerves. This major nerve leaves the pelvis bones through the sciatic notch. Your piriformis muscles involved in Piriformis Syndrome connect at one end to the bones inside your pelvis and, on the other end, connect to the top side of the hipbones, one on each hip. Your piriformis muscle helps to turn your leg and foot outward. Since the sciatic nerve is located under the piriformis muscle, problems in this muscle can cause irritation and inflammation of the sciatic nerve, leading to Piriformis Syndrome symptoms.

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