It’s Not Sciatica: Diagnosing and Treating Piriformis Syndrome

The condition referred to as “sciatica” involves pain in the buttocks traveling down the leg. The most common reason for this condition is an irritation that occurs in the spinal nerves in or close to the lumbar spine as a result of neural foraminal stenosis, often caused by a herniated or bulging disc. However, if the nerve irritation is further down the leg as a result of an injury and not in the spine, the actual injury is to the piriformis muscle. This condition – piriformis syndrome – feels similar to the pain caused by a herniated disc. Although this injury is physically disabling, only in rare cases does it require surgery.

Function of and problems with the piriformis muscle

The piriformis muscle ties the hip or top of the thigh bone to the tailbone or sacrum. This muscle enables the leg and foot to turn outward. Issues with the piriformis muscle can cause sciatic nerve pain since the sciatic nerve is positioned beneath and sometimes through the piriformis muscle, exiting the pelvis, and traveling down the leg. As the piriformis muscle compresses and irritates the sciatic nerve in this region, the individual can experience symptoms of sciatica.

The above-mentioned condition is often improperly diagnosed as sciatica or a herniated disc.

Piriformis Syndrome resulting from a work accident

Piriformis injuries can occur in work-related settings as a result of a traumatic injury, such as falling onto the buttocks, or from repetitive activities in the workplace because the piriformis induces pressure and swelling on the sciatic nerve, resulting in its inflammation. Scar tissue that is the result of healing can leave behind a more permanent and chronic injury. Injured victims may pursue a workers’ compensation claim for such an injury sustained as a result of work activities.

Piriformis syndrome after a car wreck

Many individuals who suffer injuries in car crashes face issues with their hips and lumbar region. Piriformis syndrome is a common injury suffered by car accident victims. The unnatural muscular imbalance caused by this injury, although more subtle than a broken bone or life-threatening injury, is nevertheless still painful and debilitating.

Diagnosis and treatment of piriformis syndrome

The proper diagnosis of piriformis syndrome begins with analyzing the patient’s medical history and conducting a physical exam, including radiology tests such as an MRI and x-rays. An accurate way to diagnose if the piriformis muscle is causing the pain is through a diagnostic injection into the muscle. This muscle is located deep inside the buttocks region. Therefore, the injection requires the assistance of x-ray technology such as a CT scanner, fluoroscope, or open MRI machine. The piriformis muscle is injected with an anesthetic to paralyze the muscle. If the pain disappears after the injection, the likely diagnosis of the condition is piriformis syndrome.

Treatment of piriformis syndrome often involves physical therapy along with possible injections of cortisone, Botox, or lidocaine. Usually, surgery is a much rarer option chosen – a last resort. Surgery may involve cutting the piriformis tendon that attaches to the bump on the side of the hip (the greater trochanter). The other surgical method employed is performing a cut through the piriformis muscle to relieve pressure from the sciatic nerve.

If you have sustained an injury caused by another party that exhibits symptoms of piriformis syndrome or pain in the sciatic nerve, our Oklahoma City personal injury attorneys at Cunningham & Mears can help. We can explain your possible legal remedies and pursue the compensation you deserve. To set up a free case review, call our law office today at 405.451.4029 or use our contact form.