The Chiropractic Examination For Piriformis Syndrome (Piriformis Syndrome)

Piriformis Syndrome

The chiropractic approach to diagnosing Piriformis Syndrome includes a full evaluation of your spine and pelvis and the related musculature. A functional, orthopaedic and neurological examination is also performed for Piriformis Syndrome.

• Dysfunction in the sacroiliac joints is one contributory factor, which can lead to neuromuscular dysfunction causing weakness in the other muscles in the area.
• Several activities are said to aggravate the pain in a Piriformis Syndrome such as walking, sitting, climbing stairs, performing squats and running, but they are so general and therefore unreliable for diagnostic purposes.
• A possible sign of a tight piriformis muscle is having one foot pointing outwards more than the other when you lie relaxed on your back.
• Direct palpation (touch) of the muscle reveals a taut and tender muscle, often with trigger points present causing referred pain locally or down the leg.
• Either resisted external rotation or passive internal rotation of the hip may increase the pain.
• Resisted muscle testing can be used to see if a tendinitis is present. But since the piriformis works in conjunction with several other muscles in the buttock area such as the Quadratus femoris, Obturator internus, Superior- and Inferior gemellus, it is difficult to be specific.
• If there are neurological signs and symptoms present several tests are performed to rule out a disc injury. Some of these tests are modified to find out if the sciatic nerve is being affected and irritated by the taut piriformis muscle, such as Bonnet’s test.

The diagnosis is quite straight forward and there is no need for imaging such as x-ray, CT- or MRI in most cases. The diagnosis is made from the clinical tests.

When neurological symptoms are present the chiropractor will do a full neurological examination in order to identify the cause of the symptoms. Disc herniations are the most common cause, but sometimes, although rarely, more sinister causes have to be excluded. In those cases a MRI scan is requested.

Once a specific and accurate diagnosis has been made the treatment can start.

Piriformis Syndrome

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