Updated: Oct 11
The piriformis ([TA]: musculus piriformis) or pyramidal muscle of the pelvis is a muscle found deep in the gluteal region; It is flattened and triangular in shape with an external vertex. Inside it originates from the lateral aspect of the sacral bone and major sacrocytic ligament, it is inserted at the upper edge of the greater trochanter. It is innervated by the proper branch of the sacral plexus. Its function is the extension, external rotation and abduction of the femur when the pelvis is fixed
Pyramidal Syndrome is a set of signs and symptoms that are triggered by compression or entrapment of the sciatic nerve as it passes between the Pyramidal or Piriform muscles, gemini, and obturators of the pelvis. This compression is often caused by hypertonia or shortening of the Pyramidal muscle and may be caused by overworking the muscle in that area (eg, dancers work long hours in the Pyramidal shortening position), or by over-compression ( eg: many hours sitting in a chair at the office, driving, etc.). So we are facing an injury that we can find both in athletes and in people who lead a sedentary life.
Pyramidal Syndrome causes pain in the gluteal region, in the lower lumbar region and, in many cases, radiated pain due to irritation of the sciatic nerve. It is characteristic that this radiated pain is up to knee height, thus differentiating itself from "conventional" sciatica or other alterations that can cause this type of pain irradiation.
In prevention, it is important to stretch the pelvicrochanteric muscles well, especially the Pyramidal one. In addition, as in the prevention of all muscle imbalances, it is advisable to practice physical activity to maintain good muscle tone and balance in the pelvicrochanteric region, lower extremities, lumbar and abdominal region.
Conservative physical therapy treatment tends to have good results, thus avoiding in most cases more invasive practices such as infiltrations of * anti-inflammatory or corticosteroids. The most used techniques in physical therapy treatment are deep massage, inhibitory pressures, stretching, and re-education and correction of habits or structural imbalances that have favored the appearance of this pathology.
Piriformis syndrome symptoms
Most often, patients describe acute sensitivity to the buttocks and sciatica-like pain that runs down the back to the back of the thigh, calf, and foot. Typical symptoms of piriformis syndrome may include:
a dull ache in the buttocks
pain that runs down the back of the thigh, calf, and foot (sciatica)
pain when climbing stairs or slopes
increased pain after sitting for a long time
reduced range of motion in the hip joint
Symptoms of piriformis syndrome often worsen after long sitting, walking, or running, and may improve after lying on your back.
Exercises for range of motion. Personalized program with stretching and range-of-motion exercises to help elongate muscle and decrease spasms.
Deep Tissue Massage (manual release) is believed to improve the healing process by increasing blood flow to the area and decreasing muscle spasm.