Exploring Nonsurgical Treatments for Piriformis Syndrome

Can non-surgical treatments help individuals with piriformis syndrome reduce referred sciatica pain and help restore hip mobility?

Piriformis Muscle & Piriformis Syndrome

Within the lower extremities, various muscles, ligaments, tendons, and nerve roots allow the legs, hips, and thighs, enabling individuals to be mobile and help with good posture. One of the muscles, known as the piriformis muscle, is located in the gluteal region of the lower body, which helps the major muscles with every movement and allows the individual to walk, run, and rotate at the hips. (Chang et al., 2024) At the same time, the piriformis muscle is over the sciatic nerve, the longest and largest nerve that travels through the lower limbs down to the heel and provides motor-sensory function to the lower limbs. (Giuffre et al., 2024) Environmental factors like physical inactivity, excessive sitting or standing, lifting heavy objects, or improper posture can affect the piriformis muscle and develop musculoskeletal issues in the lower extremities. We associate with certified medical providers who inform our patients of the effects of piriformis syndrome, which affects their lower body extremities and causes pain and discomfort. While asking important questions to our associated medical providers, we advise patients to incorporate various non-surgical therapies to reduce the pain-like symptoms associated with piriformis syndrome. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

 

 

Have you experienced a pins and needles sensation in your hips and thighs that make it unbearable to walk? Do you feel radiating pain that travels down to your feet? Or have you noticed tightness in your hips and glutes region when stretching? When environmental factors impact the body, especially in the upper and lower extremities, they can cause overlapping risk profiles that can develop into chronic conditions. So, environmental factors affecting the piriformis muscle can lead to a musculoskeletal condition called piriformis syndrome. Piriformis syndrome is a somatic and neuropathic musculoskeletal condition caused by excessive or prolonged contraction of the piriformis muscle. (Jankovic et al., 2013) Many individuals who have dealt with piriformis syndrome will begin to report pain in the gluteal region that is causing sensations down the leg that can compress the sciatic nerve. (Hicks et al., 2024)

 

What Triggers Piriformis Syndrome?

Three causing factors can trigger piriformis syndrome in the lower extremities. Environmental factors like excessive movement, physical inactivity, or musculoskeletal conditions can compress the sciatic nerve over time, entrapping it and causing gradual pain. Additionally, trigger points in the muscles caused by repetitive strain can lead to muscle spasms or inflammation to irritate the sciatic nerve, which may present with a different musculoskeletal condition. (Pfeifer & Fitz, 1989) Finally, many people will begin to think that the pain they are experiencing is sciatica pain instead of piriformis syndrome.

 

Sciatica-Like Symptoms

Now, sciatica and piriformis syndrome are completely different but have similar symptoms that cause them to correlate. Sciatica is caused by spinal issues affecting the lower back that causes radiating pain down the leg. Piriformis syndrome only involves the piriformis muscle pressing one sciatic nerve area, causing overlapping risk profiles. Some of the common symptoms both sciatica and piriformis are associated with include:

• Numbness
• Tingling & burning sensations
• Inflammation
• Muscle spasms & tenderness
• Pain & discomfort when sitting or standing

 

---

Sciatica: Causes, Symptoms, & Tips- Video

---

Non-Surgical Treatments For Piriformis

Luckily, numerous treatments are non-surgical and can help many individuals with piriformis syndrome find relief. Non-surgical treatments are affordable and non-invasive, customized to the person’s pain. With piriformis syndrome, non-surgical treatments can help improve pain and functionality back to the lower extremities and provide symptomatic relief from the piriformis muscle. (Vij et al., 2021) Some of the non-surgical treatments that are excellent for reducing pain-like symptoms associated with piriformis include:

• Physical Therapy: Physical therapies allow the muscles to be mobilized and stretched and decompress the musculoskeletal structures. (Gandolfi et al., 2023)
• Acupuncture: A trained acupuncturist incorporates small needles into the acupoints around the piriformis and provides anti-inflammatory effects. (He et al., 2023)
• Chiropractic Adjustments: Chiropractors utilize mechanical and manual spinal manipulation to realign the body, stretch and strengthen the affected muscles, and alleviate pain.
• Rest: Avoiding strenuous activities and sleeping on the right mattress can help reduce spinal pain associated with piriformis syndrome and improve sleep quality.

Incorporating these non-surgical treatments to reduce piriformis syndrome can help many individuals be more mindful of their bodies daily. They can be part of a daily routine in a person’s health and wellness journey in managing piriformis syndrome and reducing its pain-like symptoms. Doing so allows the lower extremities to be mobile again and the individual to be pain-free.

---

References

Chang, C., Jeno, S. H., & Varacallo, M. (2024). Anatomy, Bony Pelvis and Lower Limb: Piriformis Muscle. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30137781

Gandolfi, M. G., Zamparini, F., Spinelli, A., & Prati, C. (2023). Asana for Back, Hips and Legs to Prevent Musculoskeletal Disorders among Dental Professionals: In-Office Yoga Protocol. J Funct Morphol Kinesiol, 9(1). https://doi.org/10.3390/jfmk9010006

Giuffre, B. A., Black, A. C., & Jeanmonod, R. (2024). Anatomy, Sciatic Nerve. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/29494038

He, Y., Miao, F., Fan, Y., He, J., Zhang, F., Wang, Z., Wu, Y., Zhao, Y., & Yang, P. (2023). Analysis of Acupoint Selection and Combinations in Acupuncture Treatment of Piriformis Syndrome: A Protocol for Data Mining. J Pain Res, 16, 3265-3272. https://doi.org/10.2147/JPR.S422857

Hicks, B. L., Lam, J. C., & Varacallo, M. (2024). Piriformis Syndrome. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/28846222

Jankovic, D., Peng, P., & van Zundert, A. (2013). Brief review: piriformis syndrome: etiology, diagnosis, and management. Can J Anaesth, 60(10), 1003-1012. https://doi.org/10.1007/s12630-013-0009-5

Pfeifer, T., & Fitz, W. F. (1989). [The piriformis syndrome]. Z Orthop Ihre Grenzgeb, 127(6), 691-694. https://doi.org/10.1055/s-2008-1040313 (Das Piriformis-Syndrom.)

Vij, N., Kiernan, H., Bisht, R., Singleton, I., Cornett, E. M., Kaye, A. D., Imani, F., Varrassi, G., Pourbahri, M., Viswanath, O., & Urits, I. (2021). Surgical and Non-surgical Treatment Options for Piriformis Syndrome: A Literature Review. Anesth Pain Med, 11(1), e112825. https://doi.org/10.5812/aapm.112825

Disclaimer