Low back problems resulting in sciatica certainly get their fair share of publicity. In fact, they're the most frequently diagnosed conditions each year in the United States.
But what you may not know is that many cases of buttock and leg pain are caused by the piriformis muscle. It's a muscle that lives deep inside your hip joint which can become tight or spasm and cause pain in a very similar fashion to sciatica.
If you have pain in this area you should be examined at your first available opportunity to prevent a sudden worsening of the disorder. Because diagnostic accuracy is necessary to produce the best clinical outcome possible, your clinician will need to perform a variety of clinical tests to both your hip and back before initiating treatment of any kind.
Piriformis syndrome can be extremely painful and can linger for months. It can substantially impact your daily life in the absence of formal treatment, so read on to see some of the more common features of piriformis syndrome and whether or not you need to be seen in a clinic.
Piriformis syndrome, unlike sciatica, often worsens throughout the day. Sciatica is classically caused by mechanical problems in the low back that frequently ease with a little movement, a change in position or with walking. But because piriformis syndrome is muscular, it will likely worsen with increasing activity.
Symptoms are typically felt deep in the buttock in addition to other places in the leg. Classically, symptoms of sciatica emanating from the low back migrate to different places in the leg throughout the day. Piriformis symptoms tend to show up more consistently in the same place without much variation.
If you have stiffness anywhere in your hip you're a candidate for acquiring the condition. If you have trouble getting your shoes on, crossing your legs when you sit or experience stiffness when bending forward, you're going to have to take some steps towards regaining your mobility.
"Throbbing" and "toothache-like" pain are the two most common symptoms associated with piriformis syndrome. You may get a sharp pain or two if you move the wrong way, but generally speaking, most people describe piriformis syndrome with adjectives that suggest it feels unrelenting.
A limp is a telltale sign that you need to get checked out. It indicates that the surrounding musculature of your hip, leg and trunk are unable to maintain your normal gait. Limping invariably leads to more limping and thus more pain, so get checked out quickly — a limp can be notoriously difficult to chase away.
Don't sit directly on your wallet. Where your wallet sits in your seat pocket is exactly where the piriformis muscle lives. Prolonged compression on the muscle will pinch a portion of the sciatic nerve — which lives right underneath the muscle — and give you a case of piriformis-induced sciatica.
Joe DiVincenzo is a physical therapist and clinical specialist in manual therapy. He writes "On the Mend" weekly. Questions may be submitted to Joe by e-mail: joedivincenzo@comcast.net.
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