how to heal piriformis syndrome quickly is caused by spasm or tension of the piriformis muscle, which irritates the sciatic nerve and causes sciatic pain. A differential diagnosis must be made to determine the cause of the disorder. A bulging disc or herniated disc in the lumbar spine causes pressure on the sciatic nerve, resulting in pain, numbness and tingling in the affected extremity and is referred to as sciatica.
The treatment of a lumbar disc problem and sciatica is quite different from the treatment needed to eliminate the pain associated with piriformis syndrome. Anatomy of the Piriformis Muscle The piriformis muscle is connected to the sacrum, the triangular bone at the base of the spine, and to the greater trochanter, the bump at the top of the hip bone (thigh bone).
It is one of the muscles responsible for external rotation of the hip, that is, it helps to rotate the leg and foot outward. The sciatic nerve passes under and sometimes through the piriformis muscle on its way out of the pelvis. The muscle can compress and irritate the nerve, leading to the sciatica symptoms.
Treatment of Piriformis Syndrome
- The RICER regimen should be used for at least the first 48 to 72 hours after injury.
- This consists of rest, ice, compression, elevation and referral for medical examination.
- This regimen may not be implemented soon enough, as symptoms do not always appear until a day or two later.
- After diagnosis, treatment is started, and an ice pack or ice massage may help reduce inflammation.
- Rest is usually recommended and at least a two- to three-week break from any sports or activities that cause pain.
- Anti-inflammatory medications such as ibuprophen and naproxen are helpful in treating the pain and inflammation caused by nerve irritation.
- Corticosteroid injections with an anesthetic can be injected into the piriformis muscle.
- Oral cortisone may also be prescribed to relieve inflammation of the sciatic nerve.
- Heat packs relieve muscle spasms and reduce inflammation.
- TENS is helpful, and sometimes a low-voltage current to the area is combined with a cold application.
- Ultrasound treatments provide deep heating and are ideal preparation for deep massage.
- Deep massage and special soft tissue mobilization can be helpful.
- Custom orthotics can help with both treatment and prevention. Gait correction can reduce stress on the piriformis muscle, allowing it to relax and begin to heal.
- Botox injections can be used to paralyze the piriformis muscle so that it relaxes and relieves pressure on the sciatic nerve.
- Both type A and type B botulinum toxin are used. The injection is performed using either ultrasound or CAT 9 (computerized axial tomography). Both toxins are effective, and pain relief usually lasts more than 3 months.
- During this time, a stretching program can be started to correct the problem.
Exercise and Stretching
Once the pain is relieved, the next phase of treatment is initiated. The goal is to restore strength, power, endurance and flexibility to the injured muscles and tendons. Physical therapy includes: Stretching of the gluteal and piriformis muscles.
Piriformis stretch seated exercises target the piriformis muscle, but may also focus on the hamstrings and hip muscles to relieve pain and increase range of motion.
Strengthening the core muscles of the back and abdomen will help reduce strain on the piriformis.
Prevention of Piriformis Syndrome
- The more you can do to prevent this syndrome, the better off you will be. The most important things you should pay attention to are:
- A thorough and proper warm-up to prepare the muscles and tendons for activity. Without warming up, muscles are stiff and blood flow to the hip area is reduced, making it more susceptible to injury.
- Allow muscles to rest and recover after any strenuous activity.
- Strengthening and conditioning the muscles of the hip, buttocks and lower back will help prevent this condition.
- Keep muscles and tendons supple and flexible with a structured stretching routine.
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