Piriformis Syndrome and Massage

Piriformis Syndrome is a compression or irritation of the sciatic nerve which causes pain, numbness, tingling and/or burning in the hip and down the affected leg.

The pain will begin as a dull, aching sensation that starts in the muscle and travels down the leg.

What causes it?

The cause of this disorder is not really known. Some believe it to be caused by trauma (such as a fall), disc herniation, sitting or standing for long periods of time (on a regular basis

or just 2-3 days at a time), or from sitting with a large wallet in your back pocket (it is known as the "fat wallet syndrome"), with extended pressure on the hips and sciatic nerve.

Other causes might include:

  • Family history
  • Repetitive movements such as weight lifting, horseback riding, or gymnastics
  • Arthritis spurs in hips or on spinal cord
  • Previous back surgery
  • Lack of physical conditioning or poor body mechanics

Sciatica, or inflammation of the sciatic nerve, is the result of this extended pressure on this large nerve and the surrounding hip muscles. The sciatic nerve carries nerve sensations to the muscles of the hip, back of the thigh (hamstrings), lower leg, and foot and ankle.

This nerve, the largest nerve in our bodies, can become inflamed for many different reasons.

Forward bearing exercises, like running (especially uphill) or cycling, can also cause tightening and irritation, causing contracting and shortening of the hip muscles, which can lead to the inflammation, and eventually piriformis syndrome.

Where is the muscle located?

The muscle sits just under the Gluteus Maximus muscle (Buttock) and attaches to the hip. It is the primary muscle responsible for moving the leg in a backward motion.

What makes pain worse?

The pain will usually get worse if you bend, squat, climb stairs, or sit for long periods of time. Touching your toes may be excruciatingly painful.

What stretches are good for hip pain?

It is often treated with medication and/or a type of medical massage therapy. Stretching exercises (especially as a sciatica treatment or piriformis syndrome treatment) may be discussed in a massage therapy session.

To stretch the muscle, lie on your back and bend the knee toward your chest. Then pull the knee toward the opposite shoulder (for example, pull your right knee toward your left shoulder). If this movement produces pain, you may have this disorder.

Also, you can lay off the side of a bed on your stomach with your head, arms and chest leaning toward the floor. This exercise stretches the piriformis muscle as well as the rest of the back and hip muscles.

This DVD, Nerve Mobilization for the Back, Pelvis and Legs is one of the best massage videos that teaches how to massage the piriformis muscle to reduce pressure, pain, and burning symptoms, allowing natural healing. It also teaches massage for many other medical conditions. It addresses safety precautions, expectations and goals of treatment for many types of medical problems.

This is a short clip of that DVD:

Learn more about massage continuing education webinars from the Benjamin Institute that teach you how to for this syndrome, as well as other issues associated with hip and thigh pain disorders.

This disorder is often caused by sports movements that are repetitive in nature, and add undo stress to certain trigger points, usually through lunges, running up and down hills, or exercising on uneven surfaces.

Proper stretching and warm-up before activities are essential, as well as gradually increasing intensity. 

Piriformis syndrome can also be relieved with rest, ice and heat application rotations, and proper stretching. 

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