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.
The piriformis helps 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.
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:
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 worsen or create new injuries.
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 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:
In addition to a physical exam, a chiropractor will utilize imaging scans to rule out any other causes. This can include X-rays, MRIs, or CT scans. 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.
The Journal of the Osteopathic Medical Association. (November 2008) Diagnosis and Management of Piriformis Syndrome: An Osteopathic Approach https://jaoa.org/article.aspx?articleid=2093614
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