Treatment and Prevention of Piriformis Syndrome (Piriformis Syndrome)

Piriformis Syndrome

Treatment of Piriformis Syndrome

The RICER regimen should be implemented for at least the first 48 to 72 hours after injury.

After diagnosis, treatment will be started and an ice pack or ice massage may help reduce inflammation.

Rest is usually recommended and, at least, a two or three week break from all sports or activities that cause pain.

Anti-inflammatory medications like ibuprophen and naproxen are helpful in treating the pain and inflammation caused by the nerve irritation.

Corticosteroid injections with an anesthetic medication may be injected into the piriformis muscle.

Oral cortisone may also be prescribed to reduce the sciatic nerve inflammation.

Heat Packs ease muscle spasms and reduce the inflammation.

TENS is helpful and, sometimes, a low voltage current to the area is combined with a cold application.

Ultra-sound Treatments provide deep heating and are ideal preparation for deep massage.

Deep massage and specialized soft tissue mobilization may be useful.

Custom foot orthotics can help with both treatment and prevention. Gait correction can reduce the use of the piriformis muscle, allowing the muscle to relax and begin to heal.

A Botox injection may be used which actually paralyzes the piriformis muscle, causing it to relax, taking pressure off the sciatic nerve. Both types A and B botulinum toxin have been used.

The injection is done using either Ultra-sound or a CAT 9 (computerized axial tomography) for guidance. Both toxins are effective and pain relief usually lasts for more than 3 months.

During this time, a stretching program may be started which may correct the problem.

Prevention of Piriformis Syndrome

The more you can do to prevent this syndrome, the better off you will be. The most important things to remember are:

A thorough and correct warm-up to prepare the muscles and tendons for activity. Without a warm-up, muscles are stiff and there is reduced blood flow to the hip area, making it more injury-prone.

Let muscles rest and recover after any strenuous activity.

Strengthening and conditioning the muscles of the hips, buttocks, lower back will help prevent this disorder.

Keep muscles and tendons supple and flexible through a structured stretching routine.

Piriformis Syndrome

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