Piriformis syndrome

Question 1

What is piriformis syndrome?

Answer 1

Piriformis compresses against the sciatic nerve in the sub gluteal space

Question 2

Common causes

Answer 2

• More common in women than men (ratio of 6:1)
• Can become shortened due to poor posture: leg being held in a laterally rotated position
• Poor Lx stability can lead the piriformis developing hypertonicity as a compensation measure
• Due to external blow, muscle can become inflammed
• Linked to SIJ conditions

Question 3

Signs and symptoms

Answer 3

Referred neurological pain to posterior thigh and buttock
- Hypertonic and tender piriformis muscle on palpation
- Resisted lateral rotation and passive medial rotation of the hip may be painful
- Extended period of sitting will exacerbate pain

Question 4

Treatment

Answer 4

• MET and STR to help lengthen the muscle
• Ischemic pressure to relieve TrP in piriformis
• Address global muscles around the area for compensatory soft tissue dysfunction

Question 5

Post care advice

Answer 5

• Advise the client to reduce periods of sitting
• Educate client on flossing the nerve
• Strengthen the hip abductors and external rotators of the hip

Question 6

Special tests

Answer 6

Modified Craig’s test