Osteopath
piriformis syndrome
What is piriformis syndrome?
Piriformis syndrome is a condition in which the piriformis muscle—a deep gluteal muscle—develops increased muscle tension and can exert pressure on the sciatic nerve. This large leg nerve runs from the lower back through the pelvis and hip to the back of the leg and sometimes as far as the foot.
When the piriformis muscle contracts too strongly, the nerve can become irritated. Compression or irritation of the nerve can lead to gluteal complaints and radiating pain. Many people with long-term lower back pain or pain while sitting seek an osteopath for piriformis syndrome when the symptoms keep recurring.
The symptoms of piriformis syndrome can closely resemble sciatica or a herniated disc, as the radiating pain follows the same nerve path.
Symptoms of
piriformis syndrome
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Deep, aching, or stabbing pain in the gluteal muscle
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Radiating pain to the back of the upper leg
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Pain extending toward the lower leg or foot
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Tingling or numbness
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Loss of strength
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Increased pain during prolonged sitting (typical sitting pain)
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Pain during hip rotation or turning of the leg
Symptoms can vary in intensity and are often experienced as nerve pain along the course of the sciatic nerve. Occasionally, radiating pain extends to the foot, which makes distinguishing it from lower back issues or a herniated disc complex. Although it is sometimes referred to as inflammation, piriformis syndrome usually involves nerve irritation caused by increased muscle tension and overuse.
Osteopathic examination for piriformis syndrome
The diagnosis of piriformis syndrome is determined based on the pattern of symptoms, physical examination, and the exclusion of other conditions.
During the examination for piriformis syndrome, an osteopath assesses factors including:
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Mobility of the lower back
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Range of motion of the hip
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Hip rotation
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Stability of the pelvis
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Muscle balance of the gluteal muscles
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Signs of nerve entrapment
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Difference between left and right side
Because the clinical presentation can closely resemble a herniated disc or other lower back issues, a careful differential diagnosis is essential. This distinguishes between piriformis syndrome, a herniated disc, other forms of nerve entrapment, or chronic lower back pain.
In some cases, additional diagnostic testing, such as an MRI scan, may be required to rule out other causes. It is important to note that pure piriformis syndrome is relatively rare. In many cases, the underlying cause originates in the lower back or the pelvis.
Cause of piriformis syndrome
The cause of piriformis syndrome is often not primarily located within the gluteal muscle itself.
When there is reduced mobility in the lower back or an imbalance in the pelvis, the piriformis muscle can develop additional tension. The muscle contracts to create stability when the lower back or hip functions insufficiently. This compensation can lead to chronic symptoms and nerve compression.
Increased tension in the piriformis muscle often arises secondary to reduced mobility in the lower back or a disrupted coordination between the hip and pelvis. This can lead to increased pressure on the nerve.
Muscle imbalance plays a significant role in this. When the gluteus maximus or other hip stabilizers are insufficiently active, the piriformis muscle must perform relatively more work. This increased load can eventually cause compression of the sciatic nerve.
Prolonged sitting, poor posture, athletic strain, scar tissue, or previous injuries can exacerbate this imbalance.
Why see an osteopath for piriformis syndrome?
Many individuals with chronic or recurring buttock pain choose an osteopath for piriformis syndrome when previous treatments with a physiotherapist have yielded insufficient results.
An osteopath specializing in piriformis syndrome does not focus solely on the gluteal muscle, but also examines:
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The spine
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The lower back
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The pelvis
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The hip
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Muscle imbalance
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Connective tissue
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Nerve function
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Blood circulation
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Coordination within the kinetic chain
This not only reduces pressure on the nerve but also addresses the underlying cause.
Treatment for piriformis syndrome
The treatment of piriformis syndrome by an osteopath is not a standardized procedure. Within osteopathy, treatment is always tailored to the findings identified during the patient’s examination. The starting point is not just the pain in the buttock, but the underlying cause of the piriformis syndrome.
The treatment focuses on, among other things:
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Improving mobility of the lower back and hip
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Reducing nerve irritation
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Restoring muscle balance
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Reducing strain and overload
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Optimizing blood circulation
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Improving stability around the pelvis and hip
Depending on the findings, the cause may not only be located in the lower back or hip, but also lower or higher in the kinetic chain. For instance, an issue in the foot, knee, or even the abdominal region can influence tension in the pelvis and, consequently, the piriformis muscle.
The treatment is therefore not exclusively aimed at relaxing the gluteal muscle, but at restoring normal mobility and coordination between muscles, joints, and nerve structures throughout the entire body.
By addressing the cause of piriformis syndrome, compression of the sciatic nerve decreases. This often leads to a lasting reduction in symptoms. In rare cases, surgery may be considered, but for piriformis syndrome, this is usually unnecessary.
Do not let piriformis syndrome dictate your daily life
Are you looking for an osteopath for piriformis syndrome in Amsterdam for recurring lower back pain, pain while sitting, or radiating pain to the leg? It is then important that not only the gluteal muscle is treated, but that the entire kinetic chain is carefully examined.
As an osteopath, I usually see people whose pain in the buttock is ultimately related to the lower back or other parts of the body. By approaching the body as a whole, the cause of the piriformis syndrome can be addressed instead of just the symptom.
Curious about what an osteopath can do for you regarding piriformis syndrome? Make an appointment or contact us for more information.