Identification of piriformis syndrome or sciatica requires proper testing and examination. The piriformis muscle begins at the sacrum near the sacroiliac joint and is attached to the femur/thigh bone at the outer area of the hip. The sciatic nerve passes typically under or through the muscle before going down the back of the thigh.

11860 Vista Del Sol, Ste. 128 Testing For Piriformis Syndrome or Sciatica through Chiropractic

The piriformis helps to turn the hip outward and bring the thigh outward to one side while the hip is bent. This could be when raising the knee and bringing the leg out. An example is stepping out of a car. The muscle also helps to stabilize when walking, running, and standing. Individuals with the sciatic nerve passing through the piriformis have an increased chance of developing piriformis syndrome. It can also be called piriformis sciatica since it is not true sciatica.

Symptoms

Piriformis syndrome does not always present the same way. Common symptoms include pain, tingling, and numbness in the buttocks that becomes worse when sitting. Other symptoms can include:

  • Pain when sitting, standing, or walking
  • Pain when getting up from a seated/squatting position
  • Pain in the sacroiliac joint
  • Pain and/or pins and needles, burning, tingling, or itching sensation
  • Movement helps to reduce pain symptoms
  • Numbness in the foot

Many of these symptoms can be mistaken for sciatica. This is why proper testing is necessary to provide the appropriate treatment, otherwise, the condition could be made worse or create new injuries.

Causes

  • Primary piriformis syndrome happens when there is a splitting of the piriformis muscle, the sciatic nerve, and/or the sciatic nerve does not run along the normal path.
  • Secondary piriformis syndrome is more common and is caused by inflammation of the soft tissues, muscle spasms, or both. And the result is nerve compression.
11860 Vista Del Sol, Ste. 128 Testing For Piriformis Syndrome or Sciatica through Chiropractic
  • Direct trauma to the buttock area can definitely cause inflammation, scarring, and contraction of the piriformis muscle. This could be the result of an automobile accident, or a fall.
  • The most common cause is a progressive tightening of the muscle brought on from a weakened piriformis muscle.

Testing

Because of the close relation between piriformis syndrome and sciatica, a chiropractic medical professional will perform various tests to determine if symptoms are spinal disc-related or caused by the sciatic nerve getting pinched, or impinged by the piriformis muscle. A chiropractor will examine the low back, hip, pelvis, sacroiliac joint, walking gait, posture, and leg length. They will test various body reflexes as well. Other tests can include:

  • Palpation/manipulation of the piriformis muscle
  • A Straight leg raise will be done to see if there is localized pain when pressure is applied to the piriformis muscle and the tendon. The chiropractor will flex the hip at a 90-degree angle and extend/straighten the knee.
  • A Freiberg test will be done to see if pain presents around the piriformis or reproduces symptoms.
  • The Pace maneuver test looks for pain and/or weakness during rotation of the hip when sitting.
  • The F.A.I.R test stands for flexion, adduction, and internal rotation. This test has the individual lie on the non-affected side while the chiropractor guides the painful leg into hip flexion, turns it in toward the body, and gently turns the lower leg outward.
  • The Beatty maneuver tests for pain while lying on the non-affected side, and the chiropractor elevates the flexed symptomatic leg.
  • Testing for pain or weakness in specific positions is conducted usually for one-minute or when the individual experiences symptoms.
11860 Vista Del Sol, Ste. 128 Testing For Piriformis Syndrome or Sciatica through Chiropractic

In addition to a physical exam, a chiropractor will utilize imaging scans to rule out any other causes. This can include X-rays, MRI, or CT scan. Once the source has been diagnosed treatment can begin. Many individuals choose to wait and see what happens, hoping the problem will go away. But the sooner the root issue is dealt with, the sooner an individual can get back to living pain-free.

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References

The Journal of the Osteopathic Medical Association. (November 2008) “Diagnosis and Management of Piriformis Syndrome: An Osteopathic Approach ”jaoa.org/article.aspx?articleid=2093614

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The information herein on "Testing For Piriformis Syndrome or Sciatica through Chiropractic" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

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Our information scope is limited to Chiropractic, musculoskeletal, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.

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Dr. Alex Jimenez
Specialties: Stopping the PAIN! We Specialize in Treating Severe Sciatica, Neck-Back Pain, Whiplash, Headaches, Knee Injuries, Sports Injuries, Dizziness, Poor Sleep, Arthritis. We use advanced proven therapies focused on optimal Mobility, Posture Control, Deep Health Instruction, Integrative & Functional Medicine, Functional Fitness, Chronic Degenerative Disorder Treatment Protocols, and Structural Conditioning. We also integrate Wellness Nutrition, Wellness Detoxification Protocols and Functional Medicine for chronic musculoskeletal disorders. We use effective "Patient Focused Diet Plans", Specialized Chiropractic Techniques, Mobility-Agility Training, Cross-Fit Protocols, and the Premier "PUSH Functional Fitness System" to treat patients suffering from various injuries and health problems. Ultimately, I am here to serve my patients and community as a Chiropractor passionately restoring functional life and facilitating living through increased mobility. Purpose & Passions: I am a Doctor of Chiropractic specializing in progressive cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, functional strength training, functional medicine, and complete conditioning. We focus on restoring normal body functions after neck, back, spinal and soft tissue injuries. We use Specialized Chiropractic Protocols, Wellness Programs, Functional & Integrative Nutrition, Agility & Mobility Fitness Training and Cross-Fit Rehabilitation Systems for all ages. As an extension to dynamic rehabilitation, we too offer our patients, disabled veterans, athletes, young and elder a diverse portfolio of strength equipment, high-performance exercises and advanced agility treatment options. We have teamed up with the cities' premier doctors, therapist and trainers in order to provide high-level competitive athletes the options to push themselves to their highest abilities within our facilities. We've been blessed to use our methods with thousands of El Pasoans over the last 3 decades allowing us to restore our patients' health and fitness while implementing researched non-surgical methods and functional wellness programs. Our programs are natural and use the body's ability to achieve specific measured goals, rather than introducing harmful chemicals, controversial hormone replacement, un-wanted surgeries, or addictive drugs. We want you to live a functional life that is fulfilled with more energy, a positive attitude, better sleep, and less pain. Our goal is to ultimately empower our patients to maintain the healthiest way of living. With a bit of work, we can achieve optimal health together, no matter the age, ability or disability.