Wednesday, June 26, 2013

Piriformis Syndrome - Hip Pain, Back Pain, and Loss of Feeling Down to the Feet


One cause of back pain that actually does not involve a degeneration or injury to the tissues of the spine is referred to as piriformis syndrome. This disorder actually affects the sciatic nerve as it travels deep through the hips. The piriformis muscle crosses over the sciatic nerve as the nerve travels down from the lower back through the hips and then down the length of the leg to the foot. When the muscle puts excess pressure on the nerve, chronic feelings of pain and numbness can result from the compressive forces.

This syndrome is common in runners, people who bicycle often, and can be found in the general public as well. The piriformis muscle compresses the sciatic nerve near the site of the rotator muscles of the hip, resulting in pain and a loss of feeling. The first sign of the syndrome is a chronic ache in the hips or numbness that that be felt deep in the hips and progress down the leg or even all the way down to the foot. Typically, only one side of the body is affected, as the sciatic nerve branches out from the lower back to either leg.

With piriformis syndrome, the pain can be chronic and be felt when moving, running, walking, or even sitting down. Sitting is one activity where the sciatic nerve is directly compressed by the piriformis muscle. We have all had the experience of sitting in one position or another for too long and our entire leg falls asleep. That is the sciatic nerve "turning off" due to pressure being placed on it at the hip. Thankfully, for the vast majority of us, this is a temporary numbness and only an annoyance, but for some people it is a painful chronic condition.

Pain and discomfort can also extend upwards into the lower back and people may feel as if their lower back is the site of the injury instead of the hips. This can make diagnosing piriformis syndrome difficult for doctors, as they have to take into account the possibility that the problem is caused by a herniated disc or otherwise compressed spinal disc that may cause numbness down the length of the sciatic nerve. This is why doctors may have x-rays or an MRI done on a patient with piriformis syndrome -- to rule out the possibility of a more serious back injury.

Treatment for the disorder typically involves reducing physical activities that place pressure on the sciatic nerve. This may mean standing up more if sitting causes discomfort, as well as taking a few days or weeks off of running or biking. Anti-inflammatory medications may help to reduce swelling if there is any injury or trauma to the piriformis muscle. Stretching and strengthening exercises may be recommended for some people who can move with little discomfort, in order to strengthen and improve the tissue quality of the muscle. And the good news is that surgery is extremely rare for this disorder.

For many people suffering from piriformis syndrome, the chronic feeling of numbness traveling down the leg to the foot may be extremely uncomfortable. Thankfully, that cause of the problem is well known and often responds to treatment and rest. The muscle can be relaxed, stretched, and strengthened so that it does not cause excess pressure anymore, and the nerve can heal quickly so that normal feeling returns once the muscle has relaxed. So while the pain may be chronic once the muscle clenches and applies pressure to the nerve, it does not have to be a permanent source of discomfort for many people.

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