Sunday, February 15, 2009

Pesky Piriformis

With the advent of MRI, we seemed to have blamed all shooting pain like sciatica to discs. Slipped, bulging, herniated, torn, smashed, compressed, protruding, extruding, you name it.

And you can't blame us. On MRI, you have a pretty view of the disc. "Look, see it protruding out like that."

The problem with this is that nerves can be compressed or stretched against other tissues. Some of this tissues are hard like bone, but a lot of times they can be soft like muscle or fascia.

One such muscle that can cause a lot of trouble in sciatic-type pain is the piriformis muscle. It lies deep in the middle buttock area and can do great job irritating the largest nerve in the body that runs near it, the sciatic nerve. We title this simply Piriformis Syndrome.

People have variations in where the sciatic nerve lies in relation to the piriformis. Most of the time the nerve is under, sometimes under, and sometimes through.

Various ways have been developed to stretch the piriformis such as the figure-four stretch, to loosen the piriformis fascia with tools such as Graston or Therapy Edge, and to control movement with strapping such as with Kinesio Tape. Exercise therapy designed to stabilize other pelvic muscles and take pressure off the piriformis can be of great help as well.

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