Visit our Official Website: www.fisiositta.com.br (11)2528.4661 Call and schedule your appointment Facebook: https://www.facebook.com/fisiositta?f... LinkedIn: / robson-sit. . SUBSCRIBE on YouTube: https://www.youtube.com/channel/UCb7a... SPECIALIZED PHYSIOTHERAPY Myofascial Release of the Piriformis Muscle + Proprioceptive Neuromuscular Facilitation + Cyriax Transverse Friction Piriformis syndrome is a rare condition where the person has the sciatic nerve passing through the fibers of the piriformis muscle, which is located in the buttock. In these people, the sciatic nerve becomes inflamed due to the fact that the nerve is constantly pressed due to its anatomical location. When a person with piriformis syndrome has an inflamed sciatic nerve, it is common for intense pain to appear in the right leg, because this is usually the most affected side, in addition to pain in the buttock. Signs and symptoms The best way to know if a person has piriformis syndrome is to undergo an exam such as an MRI, CT scan or ultrasound, for example. However, the characteristics of sciatic pain in people who have this syndrome are more characterized by: Pain in the form of a sharp, stabbing, burning or tingling sensation in the buttock or behind the thigh; There may be pain in the lateral region of the leg and the top of the foot; The pain worsens when sitting and crossing the leg; The first attack may occur during pregnancy, due to increased weight and size of the belly; It is common for the person to walk with a limp during a sciatic attack; Symptoms such as leg weakness and a feeling of numbness in the buttock or leg may be present. Some situations that may favor sciatic pain in these people include an increase in the piriformis muscle due to practicing exercises for the glutes, contracture of the glutes, falling while sitting or a traffic accident, for example, which leads to a blow to the buttock region generating a hematoma that compresses the sciatic nerve. How the treatment is performed It is not possible to change the path of the sciatic nerve because the surgery creates large scars in the gluteus and causes adhesions that can cause symptoms to persist. In this case, whenever a person has sciatic pain, treatment should be done in a way that stretches and reduces tension in the piriformis muscle. Physical therapy sessions are a great treatment option to reduce pain and discomfort, and are generally very effective. Therefore, the following may be useful for treatment: Deep massage: Sit on a chair and place a tennis or ping-pong ball on the painful buttock and use your body weight to move the ball from side to side and also back and forth; Do exercises like the stretch shown in the video above, at minute 1:35, two to three times a day, every day; The myofascial release technique, which may include deep massage, can cause pain and discomfort, but it also provides great relief from symptoms in the following days; Place a warm water bottle on the painful area; The orthopedist may recommend taking medications such as ibuprofen or naproxen. If these treatments do not relieve symptoms and the pain is severe, the doctor may also recommend an injection of anesthetic and corticosteroids. Piriformis syndrome is an important cause of pain in the gluteal region, due to irritation of the sciatic nerve, resulting from increased tension or spasm of the piriformis muscle. The piriformis muscle is a small, deep muscle that originates along the anterior surface of the sacrum, running posterolaterally through the ischial groove, and ending at the greater trochanter of the femur. Its primary function is to externally rotate and abduct the hip. In most individuals, the sciatic nerve passes underneath this muscle; however, in a small portion of the population (approximately 10%), the former passes through the latter, increasing the predisposition to the onset of the syndrome. The first description of this pathology was made in 1928 by Yeoman. However, it was only in 1947 that this syndrome was described in the literature in greater detail by Robinson. He, in turn, named the pathology syndrome, as he reported six findings that made up the picture: History of trauma in the sacroiliac and gluteal region; Pain in the sacroiliac region, greater sciatic and piriformis sciatica that migrates to the thigh, causing difficulty in walking; Increased intensity of pain when the patient is in a sitting or standing position or, stopping abruptly when walking; Palpable and painful increase in volume, upon examination of the piriformis muscle by means of rectal examination; Pain during elevation of the lower limb with the knee extended while the patient is lying on the back (called Lasegue's sign); Gluteal atrophy, depending on the duration of the clinical manifestations.