Symptoms
Compression of the Sciatic Nerve
Low Back Pain
Pain referring into the buttocks
Pain referring into the posterior leg or calf
Numbness or tingling in the posterior leg or calf
Cause
Biomechanical dysfunction of the pelvis, usually the Sacroiliac Joint
Having a variant formation of the Piriformis muscle in relation to the sciatic nerve (eg bifurcated piriformis)
Direct trauma including a fall or a sports injury
Prolonged sitting
A sudden increase in activity
The piriformis muscle becomes very tight or spasms compressing the Sciatic Nerve as it exits the pelvis through the Sciatic Notch
Diagnosis
History related to the onset of pain
Palpation of the piriformis muscle spasm
Pressure on the piriformis muscle reproducing the symptoms associated with piriformis syndrome
Specific orthopedic tests to determine involvement of the SI Joints
Ruling out causes of similar symptoms (eg lumbar HNP)
Treatment
Chiropractic manipulation to restore proper biomechanics
Passive therapies to reduce pain and inflammation
Soft tissue work to relax the piriformis muscle and loosen adhesions related to the sciatic nerve
Stretching to reduce tension of the piriformis muscle and exercises to restore proper strength and stability to the area