Piriformis Syndrome

It Represents 7-8% of back pain cases each year. Piriformis Syndrome can become an unrecognized source of acute or chronic low back pain. Piriformis is a muscle that lies deep under the gluteus maximus. It originates from the anterior part of sacrum and travels through the greater sciatic notch to insert on the greater trochanter of the femur such that the muscle directly lies over the sciatic nerve. Pain occurs as a consequence of spasm in this muscle. Muscle spasm causes compression of the sciatic nerve resulting in pain that extends from the buttocks down the posterior aspect of the thigh and calf to the foot.

Piriformis Syndrome can be caused by running, cycling, weight lifting or direct trauma such as fall hitting the buttock region. In Piriformis Syndrome, the straight leg raising test will be negative. This differ the disease from spine pathology. It’s diagnosed by the pattern of pain that is reproduced by applying pressure over the sciatic notch.

Treat the muscle spasm, if necessary. Stretching the lower back gently and moving helps to break the spasm. If stretching causes excessive amounts of pain, you have to consult a doctor. Stretching should help resolve the muscle contraction.

Any vatahara drugs will have beneficial effect on the patients. Rasnasaptaka, Ashtavargam, Gandharvahasthadi are the drugs of choice. It is also advised to educate the patient regarding the diet and bowel habits. The bowel habits can be regularized by Nirgundyadi eranda etc.