Piriformis Syndrome. A pain in the bum!

Piriformis Syndrome. A pain in the bum!

Piriformis syndrome is a common ‘self-diagnosis’ for pain in the bum associated with sciatica-type symptoms. I prefer to describe it as a pain in the bum and leg and not to use the term ‘Piriformis Syndrome’ for 2 reasons.

1) Modern pain science tells us that we are often wrong when we make a specific diagnosis about a structure that is causing pain in the body and I don’t like telling my patients something that I know is likely to be untrue, even if I think it might in many cases be a harmless short cut.

2) It’s a very specific diagnosis leading us to think one muscle, ‘The Piriformis,’ is the root of the problem. One can get very fixated on that idea which may close the mind to other possible explanations for the pain. I often think this is true when clients come to see me with piriformis syndrome following failed treatment elsewhere. They often describe a previous treatment where the osteopath or physiotherapist has been fixated on trying to stick an elbow in the piriformis muscle to ‘release it’ and not a lot else has happened. Other possible approaches that might be beneficial such as addressing the sensitivity of the sciatic nerve with manual techniques like ‘flossing’ or more remote techniques like movement education to relax the glutes which interestingly I often combine with exercises to strengthen the glutes just don’t seem to enter the equation.

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