Piriformis Syndrome and treatment
A very common complaint people go to a chiropractor for is low back pain that causes pain into your buttock. At Doroski Chiropractic Neurology in the Woodbridge, Lake Ridge, Dale City VA area we see a fair amount of this complaint. Most people think sciatica or disc injury whenever they get pain in to the leg. This is a legitimate concern but it could be something much simpler but no less painful. Chiropractors have a very high success rate at treating piriformis syndrome and should be one of the first healthcare providers you consult.
Anatomy
The piriformis muscle originates from the anterior (front) part of the sacrum, the part of the spine in the gluteal region, and from the superior margin of the greater sciatic notch (as well as the sacroiliac joint capsule and the sacrotuberous ligament). It exits the pelvis through the greater sciatic foramen to insert on the greater trochanter of the femur. Its tendon often joins with the tendons of the superior gemellus, inferior gemellus, and obturator internus muscles prior to insertion.
The piriformis, pyramidal in shape, lying almost parallel with the posterior margin of the gluteus medius.
It is situated partly within the pelvis against its posterior wall, and partly at the back of the hip-joint.
It arises from the front of the sacrum by three fleshy digitations, attached to the portions of bone between the first, second, third, and fourth anterior sacral foramina, and to the grooves leading from the foramina: a few fibers also arise from the margin of the greater sciatic foramen, and from the anterior surface of the sacrotuberous ligament.
The muscle passes out of the pelvis through the greater sciatic foramen, the upper part of which it fills, and is inserted by a rounded tendon into the upper border of the greater trochanter behind, but often partly blended with, the common tendon of the obturator internus and superior and inferior gemellus muscles.
The piriformis muscle crosses over top of the sciatic muscle and if the muscle spasms it will compress the sciatic nerve and cause pain in to your buttock and leg. Once you have been properly diagnosed by your chiropractor or healthcare provider it is time to start treatment.
Treatment
Now that we know what the piriformis is and how it can cause us pain by compressing the sciatic nerve stretching it is one of the first things you should try. Video
Lie on the back with the legs flat. Pull the affected leg up toward the chest, holding the knee with the hand on the same side of the body and grasping the ankle with the other hand. Trying to lead with the ankle, pull the knee towards the opposite ankle until stretch is felt. Do not force ankle or knee beyond stretch. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.
Lie on the floor with the legs flat. Raise the affected leg and place that foot on the floor outside the opposite knee. Pull the knee of the bent leg directly across the midline of the body using the opposite hand or a towel, if needed, until stretch is felt. Do not force knee beyond stretch or to the floor. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.
Lie on the floor with the affected leg crossed over the other leg at the knees and both legs bent. Gently pull the lower knee up towards the shoulder on the same side of the body until stretch is felt. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.
These stretches work great for after care and between visits but active care may be needed by your chiropractor to help eliminate any other causes of the sciatic compression.
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Doroski Chiropractic Neurology
3122 Golansky Blvd, Ste 102
Woodbridge VA 22192
703 730 9588