Orthopedics-Online

Symptoms of Piriformis Syndrome

introduction

Piriformis syndrome is a neuromuscular disease that occurs when the sciatic nerve is irritated by the piriformis muscle. This irritation can result from the piriformism muscle pressing on the sciatic nerve, or from constricting or irritating it in various other ways. The irritation of the sciatic nerve creates characteristic symptoms. For the treatment of this disease, conservative methods are particularly suitable, such as physiotherapy especially for the piriformis syndrome.

Read more about the topics here: Piriformis Syndrome and Causes of Piriformis Syndrome

Symptoms

Usually the anatomical proximity of the piriformism muscle and the sciatic nerve does not cause any discomfort. When the piriformis muscle is tight, shortened, or inflamed, it tends to enlarge (hypertrophy). Due to the increased space required in the pelvis, this can irritate the sciatic nerve, which can lead to a number of different symptoms.

General symptoms

Most often, piriformis syndrome begins with a sharp pain in the buttocks. In addition to the sharp pain, patients often complain of tingling and numbness in the buttocks region; characteristic symptoms associated with nerve compression. In addition to its localization in the buttock area, the pain can often radiate along the course of the sciatic nerve into the back of the thigh. In addition, patients sometimes complain of tingling and numbness in the calf, foot, and even down to the toes.
In addition to pain in the buttocks and legs, piriformis syndrome can also cause pain in the lumbar region (lumbar spine) of the back, so that a herniated disc in the lumbar spine must be excluded when making a diagnosis in order to ensure effective treatment. This must be thoroughly examined clinically by the attending physician, as a herniated disc of the lumbar spine can also press on the sciatic nerve in the event of a herniated disc.

Read about this too Pain in the left buttock and herniated disc in the lumbar spine.

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The pain is especially acute when walking up stairs or generally up a hill, as it increases the stimulus to the sciatic nerves.

Symptoms occur more frequently even after sitting for a long time. Due to the symptoms, the patient has limited movement in the hip and is noticeable for a relieving posture and increased hobbling. In contrast, prolonged lying down of the patient can relieve the pain.

If the pudendal nerve is also affected in addition to the sciatic nerve, patients complain of tingling and numbness in the perineal and genital regions and possibly even bladder and bowel emptying disorders.

Symptoms when sitting

Piriformis syndrome causes a number of typical symptoms, most notably pain. Often they occur while sitting. This is due to the fact that a large part of the body weight lies on the buttocks and thus on the tense muscles in piriformis syndrome, which leads to further irritation of the nerve fibers. The pain can occur immediately after sitting and get worse over time. Existing pain worsens when you sit down. It is also possible that symptoms may only appear after a long period of time when sitting, possibly together with a tingling sensation.

Piriformis syndrome causes symptoms of this type, especially on hard surfaces such as wooden, stone chairs or benches. They occur a little less if you use soft surfaces such as pillows. The pain when sitting is mainly localized in the buttocks. Due to the course of the irritated sciatic nerves, symptoms can also be found on the back of the thighs, in the groin or a little higher in the lumbar vertebra area.

Read more about the topic here: Duration of Piriformis Syndrome and What is the Best Therapy for Piriformis Syndrome?

Symptoms when walking

The symptoms of piriformis syndrome can worsen under stress, such as when walking.

In addition to the symptoms when sitting, piriformis syndrome typically also causes pain when walking. The piriformis muscle is involved in walking, so symptoms such as pain in the thigh, lumbar vertebrae and buttock area can often be observed. These can be present at the beginning or arise after a long walk. Due to the physiological function of the piriformism muscle, these symptoms occur particularly when climbing stairs.

In piriformis syndrome, climbing stairs is associated with pain. In general, symptoms such as tingling or numbness can also occur in the affected area. One theory assumes that pain is also relieved by walking, as the movement in the muscle loosens it a little and the tension decreases. However, one should not strain oneself beyond the pain and seek medical advice.

Symptoms at night

Many patients report that piriformis syndrome pain also occurs at night. They are comparable in character and appearance to the pain that occurs during the day. The pain at night can be dull, stabbing, and variable in strength, accompanied by a tingling sensation in the legs or feet. The pain can also radiate to the thighs and back. These symptoms mainly occur when you have been lying on the affected side the whole time at night and have put more stress on it than usual.

Therefore, when lying down, you should be careful not to lie on the affected side, which unfortunately cannot be controlled while sleeping. In addition, with piriformis syndrome, the pain occurs at night mainly from turning from one side to the other. Because here the muscle that causes the pain carries the rotation. Symptoms can be relieved by using a soft pillow that is squeezed between your legs on your healthy side before going to bed. Often this measure brings an improvement in pain.