The piriformis muscle is presented in the form of an isosceles triangle. Its base is located on the front plane of the tibia, and the apex is in the region of the greater femoral trochanter.
The piriformis muscle, through a large opening (sciatic), leaves the cavity in the small pelvis, then passes along the posterior region of the hip joint. She attaches to the spit of the thigh, moving into a short and narrow tendon.
The piriformis muscle forms the lower and upper cleft. Thus, it does not completely occupy the sciatic opening.
The piriformis muscle is responsible for hip abduction and rotation. With a fixed position of the leg, it has the ability to deflect anteriorly and toward the pelvis.
The muscle is innervated by the branches of the joint of the sacrum, from the spinal roots (S-1 and S-2). Blood supply is carried out through the lower and upper arteries of the buttocks.
Pathological tension in the piriformis muscle creates the conditions for the occurrence of compression. The inferior gluteal artery and sciatic nerve are involved in the process . Their compression occurs between the dense ligament (sacrospinous) and the muscle itself.
The condition may be primary. In this case, it is caused by pathological changes in the muscle itself. The secondary occurrence of the condition is due to external spasm and compression.
Pathological changes of a primary nature can be caused by myofascial pain syndrome. The immediate causes of its development include sprains, overtraining, hypothermia, injuries in the gluteal and lumbosacral zones. In addition, soreness of this nature is often caused by an unsuccessful injection, prolonged exposure to an analgesic posture, ossifying myositis.
Due to diseases in the sacroiliac joint, pelvis, gynecological nature in particular, secondary piriformis syndrome may develop . Symptoms of the disease manifest as painful aching or burning in the buttock. At the same time, it can give on the back plane of the lower leg and thigh. In addition, the condition is accompanied by difficulties in bending the leg. Together with weakness in the lower leg or foot, a feeling of numbness along their outer edge is noted. Integuments change color (as a rule, become cyanotic or pale), become dry. In many cases, a characteristic sensation of chilliness arises in the affected limb. Convulsions in it can lead to intermittent claudication. The patient feels pain when bringing the limbs together (bringing the thigh).
It should be noted that this disease prognosis is favorable and successfully treatable. As practice shows, its occurrence is associated with prolonged physical activity with degenerative damage in the spine (osteochondrosis). Therefore, the doctor’s attention when prescribing therapeutic measures is drawn, as a rule, to preventing the progression of the process. That is why it is recommended to consult a doctor as soon as possible.
Therapeutic measures have a similar direction as those prescribed for instability of the spine or compression in the nerve roots of its lumbosacral zone.
The main therapeutic manipulations are based on eliminating the cause of the ailment.
Severe pain involves prescribing medications with the ability to reduce spasm in the paravertebral muscles. The chronic nature of the condition is advisable and more effective to eliminate using physiotherapeutic procedures. Such events should include:
- spinal traction;
- medical gymnastics;
- special massage;
- acupuncture.
For relaxation, piriformis exercises are recommended.
The patient assumes a supine position with bent legs, resting on the couch with soles. Next, you should perform smooth movements of breeding and connecting the knees.
With bent legs energetic shocks are made - one knee pushes the other - for three to five seconds.