It is an unfamiliar ailment to the average person, and in fact, it is an uncommon neuro-muscular disorder. However, the symptoms are quite similar to that of sciatica. It is where the piriformis muscle irritates the sciatic nerve and causes pain in the rear, and may cause pain along the back of the leg and into the foot.

The piriformis muscle:

• Starts at the lower spine and connects to the upper surface of each femur (thighbone).

• Functions to assist in rotating the hip.

• Runs horizontally, with the sciatic nerve running vertically directly beneath it.

Piriformis syndrome can develop when the piriformis muscle becomes tight or spasmodic, and places pressure on the sciatic nerve.

Signs and Symptoms

Piriformis syndrome usually starts with pain, tingling, or numbness in the buttocks. Pain can be severe and extend down the length of the sciatic nerve (called sciatica). The pain is from the piriformis muscle compressing the sciatic nerve, such as while sitting on a car seat or running. Pain may also be triggered while climbing stairs, applying firm pressure directly over the piriformis muscle, or sitting for long periods of time. Most cases of sciatica, however, are not due to piriformis syndrome.

Diagnosis

A physical exam will include examination of the hip and legs to see if movement causes increased low back pain or leg pain (sciatica pain). Typically, motion of the hip will recreate the pain.

X-rays and other spinal imaging studies cannot detect if the sciatic nerve is being irritated at the piriformis muscle. However, diagnostic tests (such as X-rays, MRI and nerve conduction tests) may be conducted to exclude other conditions that can cause similar symptoms to piriformis syndrome like disc herniation, for example.

Depending on the severity of the patient's sciatica-type pain and other symptoms, a number of treatment options may be recommended by a health care professional. A comprehensive approach to managing pain along the sciatic nerve from piriformis syndrome may include a combination of:

• Stretching

• Icing the area

• Heat therapy

• Physical therapy

• Medication

• Injections

• Electrical therapy

Treatment

It's important to pay attention to the activities that trigger your symptoms. If pain is caused by sitting or certain other activities, try to avoid positions that activate it. Rest, ice, and heat may help relieve symptoms. A doctor or physical therapist can suggest a programme of exercises and stretches to help reduce sciatic nerve compression. Some health care providers may recommend anti-inflammatory medications, muscle relaxants, or injections with a corticosteroid or anaesthetic. Other therapies such as massage and electrical can also help. Surgery may be recommended as a last resort.

Prevention

Since piriformis syndrome is usually caused by sports or movement that repeatedly stresses the piriformis muscle, for instance running or lunging, prevention is often related to being in good form. Avoid running or exercising on hills or uneven surfaces. Warm up properly before activity and increase intensity gradually. Use good posture while running, walking, or exercising. If pain occurs, stop the activity and rest until pain subsides. You should check a doctor as needed.

Your feet mirror your general health . . . cherish them!

Leana Huntley is an English trained foot health practitioner attached

to ALMAWI Limited –

The Holistic Clinic. Call to make an appointment at 662-1732 or

lhuntley@almawiclinic.com Tuesday - Saturday. Check for the Clinic at www.almawiclinic.com.