Piriformis Syndrome Symptoms and Diagnosis
Although there is no definitive diagnosis for piriformis syndrome, if there is a presence of sciatica symptoms in the posterior thigh or lower leg, combined with soreness or tenderness in the sciatic notch area, this usually points towards piriformis syndrome.
Magnetic Resonance Neurography - This is an imaging technique that is performed to find out if there is any sciatic nerve irritation present in the sciatic notch. In most people this is where the sciatic nerve passes under the piriformis muscle. The sciatic nerve passes through the piriformis muscle instead of under it in fifteen percent of the general population. The use of this test may also show if the patient has either a split in the sciatic nerve or the piriformis muscle.
Image Guided Injections - This is the most reliable injection procedure for diagnosis of piriformis syndrome. It is carried out in an open MRI scanner so that the injection can properly relax the piriformis muscle leading to a more accurate diagnosis. Flouroscopic guided injection, ultrasound, blind injection, or EMG guided injection are other methods use to diagnosis the syndrome but are not as accurate as an imaged guided injection.
Piriformis Syndrome Treatment
With most back conditions treatments begin with as minimally aggressive as possible to try and give the natural healing process a little boost. With piriformis syndrome early treatment may consist of avoiding activities that may aggravate the condition, combined with exercise and massage. Two of the major activities you should avoid while healing piriformis syndrome are running and bicycling. You should avoid these activities until your doctor give you the “green light”.
Physical therapy can help to teach a patient the proper technique they can use for stretching and strengthening the core muscle group. The techniques will help reduce strain placed on the piriformis muscle. Physical therapy also teaches stretching exercises that target the piriformis muscle, the hamstrings and the muscles in and around the hips. This will help to increase the patient’s range of motion and help to alleviate some of the pain and discomfort.
Other forms of piriformis syndrome treatment may include ice and heat, and piriformis massage from a massage therapist. In the initial stages of the piriformis injury ice may be helpful in reducing the pain felt. After a few days, begin to alternate the ice pack with a heat pack, or heating pad.