Common Piriformis Injury Causes

Sometimes, when you pull a muscle, you can tell exactly where it is by where you're feeling pain. But when you're dealing with piriformis injury symptoms, it's not always obvious. That's why it's important to know the symptoms, but it's also important to understand how the piriformis injury causes. First, because you may be able to avoid injury in the first place. Second, if you're feeling symptoms, you might be able to trace it back to the point of injury, which will help determine what type of injury you have.

How Can You Injure the Piriformis Muscle?

It is shockingly easy to injure the piriformis muscle. As you fully extend your leg, whether it is during a walk, cycle or swim, it is the gluteus maximus that is primarily responsible for this movement, but there are external rotators that help. Those rotators are also hard at work whenever the leg is rotated. If, for any reason, the rotators are used for an extended period of time, they are likely to experience injury. This may happen as a result of a muscle imbalance or muscle weakness (where the rotators pick up the slack for weaker muscles).

Let's take a look at some common examples:

1. Hyper- or Hypopronation of the Ankle. Whenever there are issues with the ankle, it is common to see the entire leg rotate to overcompensate. So, instead of engaging the leg, the action is shifted up to the hip extensors, which includes the hamstrings, glutes and external rotators.

2. Weak Abductor Muscles. Abductor muscles help to stabilize the pelvis while you walk, so it stays level as you switch from foot to foot. Just more proof that our bodies work a whole lot harder than we realize. But these muscles often become overused and weak, which causes the adductor muscles to become tight and potentially contracted. Since adductors help with hip extension and rotation, this domino effect extends to impact hip extension, putting pressure on the external rotators, which then puts them at risk for injury. Essentially, when one muscle doesn't work properly, others have to pitch in to get the job done, stretching them too thin.

Is a Piriformis Injury the Same as Piriformis Syndrome?

Not necessarily. Piriformis syndrome is caused by a piriformis injury, but a piriformis injury does not necessarily cause piriformis syndrome. Confused yet? Think of the injury as a simple muscle strain. If that strain becomes inflamed or begins to spasm, it may put pressure on the sciatic nerve. If this happens, the injury becomes piriformis syndrome.

Either way, it is important to treat the piriformis injury so it doesn't get worse. Fortunately, stretching has been proven to help in both situations. The main issue is that it's difficult to know when you are properly stretching that muscle, which is why we produced the Piri-Stretcher®.The Piri-Stretcher® is registered with the FDA as a class 1 medical device, and it is used to treat piriformis syndrome and sciatica.

Piriformis Syndrome and Acupuncture

Have you ever heard anyone say that Piriformis Syndrome is rare? Well, it's probably not as rare as those may think. Many cases of this syndrome are categorized under the blanket of “low back pain”, and so, they may not be treated properly. 

Low back pain can be treated a number of ways, depending on its root cause; and it definitely helps to know whether it is a disc or a muscle that is causing your pain. Since piriformis syndrome, at its root, is a muscle issue, we've decided to explore acupuncture as a treatment in this week's post.

Acupuncture as Treatment for Piriformis Syndrome

Much like with any other treatment, acupuncture for PS starts with a thorough examination. The practitioner will attempt to locate the area where the nerves are pinched. For example, if the patient is experiencing pain in the buttock area, the nerves are likely being compressed in the inferior gluteal region.

Many practitioners claim they can spot piriformis syndrome on sight because the patient tends to lean toward the unaffected side while sitting or standing in order to reduce sciatic nerve compression. Patients with these symptoms also rely on heavy doses of ibuprofen or naproxen to dull the pain. Of course, this isn't enough of an exam to diagnose piriformis syndrome, though. It is recommended that patients see the general practitioner, and then, likely, a specialist for their diagnosis before they seek a treatment such as acupuncture.

Typically, an acupuncturist will use gauge #36 Chinese acupuncture needles of 1.5 to 2-inches in length. Treatment is done with a micro-current device and is focused on two to four trigger areas on the piriformis muscle itself.

Most acupuncturists suggest that patients seek treatment one to three times per week. The frequency will depend on the level of pain they are experiencing. Many patients experience some level of relief by their eighth treatment. This may include improved range of motion and reduced pain and tingling.

Piriformis Syndrome and Stretching

Although piriformis syndrome may improve with acupuncture treatment, acupuncturists also recommend stretching the muscle to aid in treatment. Check out this excerpt from a 2002 Acupuncture Today article:

“A course of daily stretching exercises is recommended (part of the protocol) to patients to assist in recovery of the muscles and tendons.”

The article goes on to recommend posture training as part of treatment, which makes perfect sense because posture is such an important part of maintaining back health.

We've found that many patients have trouble targeting the piriformis muscle with their at-home stretches, which is why we developed the Piri-Stretcher®.

The Piri-Stretcher® is an FDA registered medical device that is specifically designed to help the user target their stretch to the piriformis muscle in order to strengthen the muscle and speed up recovery time.

The bottom line about acupuncture for piriformis syndrome is that it may be effective, but it works best when combined with a daily or weekly stretching regimen. 

Alternative Methods for Pain Management

When you're first prescribed pain medication, it may seem like a happy day. Not that you're a fan of drugs or anything, but the medication seems give hope for an an end to your pain. It even works for a short time – until you have to start taking more, and then more still. And then you realize that you're more reliant on these pills than you would like to be. And where you could see an end to your pain before, now you just see a road that leads to addiction.

With 31 million Americans suffering from low back pain alone, this is an issue that affects a great number of people in our country. So, how can we manage pain without relying on medications with serious side effects and risks of addiction? There are quite a few natural pain relievers out there. The key is finding the right one, or combination of ones, that works for you.

Stretching

A staggering 70 to 80 percent of low back pain is muscle related; this is due to conditions such as sciatica, Myofascial pain and piriformis syndrome. Stretching can help loosen tight muscles and begin relieving pain that may be caused as a result of muscle tension. As an example, piriformis syndrome is caused when the piriformis muscle, one of the lateral rotators buried deep to the gluteal muscles, is stressed or tight and puts pressure on the ever-important sciatic nerve. This pressure causes an array of pain in the lower back, buttocks, and legs; and often leads to Sciatica. By using a therapeutic tool, such as the Piri-Stretcher®, to target stretches to the correct muscle, patients increase strength and mobility and can begin to heal the muscle that is at the root of so much pain.

Lifestyle changes

No one wants to hear this, but if you're carrying around some extra weight, this may be causing or contributing to your pain – especially if that pain is in your back. Diet and exercise can help you shed the problematic weight, which can help relieve your pain. This method alone may not eliminate the pain entirely, but depending on how much weight you lose, it can make a major impact.

Chiropractic care

If your pain is in the back, a good chiropractor may be able to help relieve it for you. Chiropractors are trained in healing the back and keeping it healthy, and they employ various methods to help get your back into proper alignment and keep your muscles from tensing up. The right chiropractor will find the root cause of your issue and begin a treatment plan to help you get better over the long term. This method is aimed at actually healing what ails you, and not just covering up the problem with medication.

Low back pain sufferers incur a wide array of costs from pain relief methods including surgery, physician visits, X-rays, MRI scans, medications and injections in order to try to make pain go away. Some of these costs are necessary in order to identify and start treating the problem. Others are likely to mask the symptoms, which may do more harm than good in the long run. Instead of covering up the problem, maybe it's time to start making real progress with a pain-relief program targeted at solving the underlying issue.

Stretches for Piriformis Syndrome: Do They Work?

In the interest of full disclosure, we sell a product that helps with piriformis stretches. But we're not promoting stretching because of the product, we've actually produced the product because we know that stretching helps, and we wanted to make it easier for people to target the piriformis muscle in their stretches. 

Okay, so now down to the nitty gritty. We don't expect you to take us on our word that stretching works. Let's look at the results of a few studies and articles published in peer-reviewed medical journals.

1. Piriformis syndrome: a rational approach to management. This article was published in the December 1991 issue of the journal Pain, and as promised in the title, it outlines a rational approach to managing piriformis treatment. The approach is as follows:

     1. Correct any underlying issues that may be causing piriformis syndrome

     2. Prescribe an at-home program of muscle stretching, which may be augmented with physical therapy.

     3. A trial of steroid injections may be attempted (although more recent studies have found that this may not be the best course of action any longer).

     4. If all else fails, consider a surgical intervention.

2. The Effectiveness of Electrotherapy with Manual Therapy in the Treatment of Piriformis Syndrome. In this 2012 International Journal of Rehabilitation Sciences study, researchers divided 50 patients with piriformis syndrome into two groups. The control group underwent electrotherapy and the experimental group underwent manual therapy (including soft tissue and joint mobilization techniques with stretching exercises. Both groups had regular physical therapy sessions for three weeks and were taught a self-care plan to use at home. Researchers found that the experimental group of stretchers scored lower on total disability tests at the end of the study than those in the control group, leading researchers to conclude that stretching with soft tissue and joint mobilization is a more effective treatment for piriformis syndrome than electrotherapy.

3. The Piriformis Syndrome. In clinical study, as noted in the American Journal of Orthopedics, researchers concluded that a surgical intervention is rarely necessary to treat piriformis syndrome, and conservative treatments are sufficient in most cases to treat symptoms, such as buttock pain, radiating anterior thigh, groin or lower limb pain, pain while sitting, and low back pain associated with piriformis syndrome. Patients in this study used stretching and other conservative treatments such as ultrasound, local massage and eliminating negative habits.

Now that you have the data, talk to your doctor about piriformis treatment methods. If you're interested in learning more about our medical device to help with stretching, visit our website at www.MiracleStretch.com. Here, you'll find more information on piriformis syndrome and recommended stretching exercises. 

The True Cost of Back Pain

What's the most common reason people visit the doctor's office? Okay, well that happens to be the common cold, but low back pain (LBP) is up there. This condition results in billions (with a “B”) of dollars in medical and labor costs every single year.

And although LBP isn't the number one reason people visit the doctor's office, it is among the top reasons people visit the emergency room. In fact, in 2008, there were an average of 9,400 daily emergency department visits for back pain across the U.S. And that's just the beginning. Let's take a closer look at the true cost of back pain.

Back Pain Treatment Costs

According to Medicare data collected from 1996 to 2004, there was a 629 percent increase in expenditures for epidural steroid injections, a 423 percent increase in opioids prescribed, and a 307 percent increase in spinal infusions. Even with the costs set aside, these numbers are frightening. A 423 percent (!) increase in opioids prescribed? How many more spinal infusions? Yikes.

So, with all of this back pain treatment, there must be a reduction in disability, right?

Wrong.

Social Security disability statistics note that musculoskeletal disorder disability has risen 4.8 percent from 2004 to 2005.

Now for some good news...

Physical therapy has been shown to be an inexpensive yet effective treatment for back pain. A 2007 Annals of Internal Medicine review found that manual physical therapy and exercise are effective at treating both sub-acute and chronic low back pain.

A 2009 Journal of the American Academy of Orthopaedic Surgeons found that a treatment program that combines physical therapy with anti-inflammatory medications is the most effective treatment for most cases of symptomatic lumbar degenerative disc disease, a common cause of low back pain.

Consumer Reports continues to rank physical therapy among the top treatment choices for readers with back pain, according to a 2009 survey of more than 14,000 Americans with back pain. Other “hands-on” therapies also ranked higher on this survey than the expensive and often invasive treatment methods mentioned above, which leaves us with the conclusion that patients would be wise to seek out more conservative options at their first attempt to treat back pain. Not only do they stand to save on medical bills and missed days of work, but they also may sidestep side effects and risk factors associated with more invasive methods of treatment.

Stretching is one hands-on therapy that has also proven to be effective for treating low back pain, and it's one that can be done in the comfort of a patient's home. Using the Piri-Stretcher®, patients can target their stretch to the piriformis muscle that is the cause of low back pain for many individuals. The piriformis muscle, when damaged or stressed, can put pressure on the sciatic nerve that controls feeling in the lower back and limbs. Treating the cause of the problem by stretching the muscle is not only cost effective, but it also comes without side effects and with little to no risk involved.

Importance of a Home Exercise Program (HEP) and Why It's So Hard to Follow Through

You left the physical therapist's office feeling like you were on top of the world. You're doing well with training, and are ready to spend less time at the clinic and more time with your Home Exercise Program (HEP).

But as convenient as it sounded a few weeks ago, you just can't seem to motivate yourself to follow through on your HEP. It just seems to eat away at your free time, and although you know it'll help your recovery, you just can't seem to motivate yourself to follow through. Why? Well, when we're left to our own devices, it's much easier to forget the things that should be motivating our actions to start and we lose confidence in how to even do the HEP on our own. After all, we're not trained chiropractors or physical therapists. So sometimes, not only do we need a little help with a stretch, but we need a little reminding.

Why is a Home Exercise Program Important?

Physical therapy is an important part of physical recovery programs. So, if you want to ensure that you'll return to your everyday activities in spite of injuries like Piriformis Syndrome, you'll have to work at it. An orthopedic surgeon or physical therapist will likely recommend a minimum of 10 minutes of exercise a day for three days a week. Although your therapist will likely work with you to ensure that you know how to perform these exercises correctly, you will be on your own to schedule and perform these exercises without supervision.

What Does the Research Say?

Many people find it easy to set aside 10 minutes of exercise because they don't understand how much it can help. In fact, according to a 2006 Physical Therapy study, 37 percent of patients who receive a HEP do not follow through with the plan. One or more of eight barriers seem to stand in the way. Poor health, weather, weakness, depression, fear of falling, shortness of breath, low expectations and lack of interest are all reasons people cite for not following through with a post-discharge exercise program.

How to Make HEP Adherence Easier

Have you ever told a little white lie to your doctor or health advocate? We've all been there...

“How often do you exercise? Do you smoke? Do you follow a healthy diet?”

These are all questions that we as patients are notorious for, well, fudging. Maybe we feel guilty, but there are benefits to honesty in most cases.

In fact, we're only hurting ourselves by fudging the truth. If you're honest with your physical therapist, chiropractor or orthopedic surgeon about your aversion to exercise, he or she may offer solutions that make it easier for you to stick to your HEP. For example, your medical professional may suggest a Piri-Stretcher® to help with recovery from Piriformis Syndrome. The therapy tool is used to treat Piriformis Syndrome and Sciatica in adults, and it can be used at home as part of a home therapy program for a target piriformis muscle stretch. It helps you complete the stretch on your own, and it's more fun having a tool to help. So you can make the most out of any 10- or 30-minute window in your day. 

Top 5 Reasons to Consider Piriformis Syndrome Exercises

If you’re dealing with piriformis syndrome, you’ve probably tried just about everything to help reduce symptoms. Piriformis syndrome symptoms range from a minor annoyance to a major disturbance.

It all starts with pain, tingling or numbness in the buttocks. Even in the early days, the pain may be severe and extend down the length of the sciatic nerve. If you know anything about sciatica, this should all sound familiar. It is, in fact, a form of sciatica. The cause is what sets it apart from other forms. In all cases of piriformis syndrome, the sciatic nerve is somehow impeded by the piriformis muscle.

So, what can you do to ease the pain? There are a few different treatments and pain management methods, but few are recommended as often as piriformis syndrome exercises.

1.   You want to avoid surgery at all costs. Surgery is a very extreme treatment for this syndrome. If you’re in serious pain, you might think this is the only option. But if you haven’t tried piriformis syndrome exercises, you may want to hold off on the surgery until you do. Your doctor should be able to help you make the call. But just to be clear, piriformis syndrome exercises aren’t just any old exercises. These workouts and stretches are meant to target the piriformis muscle specifically, so it may begin the healing process.

2.   You like your doctor, but would love to see her less often. You know what happens when you start feeling better? You see the doctor less frequently. And regardless of how much you like him or her, that’s always a good thing. Piriformis syndrome exercises have helped many people find relief from pain, so they can spend more time living life and less time in the waiting room.

3.   You want to increase flexibility. Do you sometimes feel tightness in that muscle? If so, that may be contributing to your condition. Exercise can help loosen things up.

4.   You’re tired of feeling pain and numbness. We don’t have to be mind readers to know that with piriformis syndrome, you have days where you say, “Enough is enough!” Enough pain; enough numbness; enough living anything less than a full life. In a clinical study noted by Parziale and other researchers, they found that conservative treatments, such as stretching, is sufficient treatment in most cases of Piriformis syndrome. 

5.   Your doctor told you to! Let’s be honest, now. You’re reading this and nodding your head because you already know most of these reasons to consider piriformis syndrome exercises – because you’ve heard them from your doctor. If you haven’t already heard this from your doctor, schedule some time to have a quick chat about exercise and stretching, so you can be sure your doctor is on board with this form of treatment.

If you want help targeting your exercise to the piriformis muscle (it can be a challenge if you don’t know what you’re doing), consider the Piri-Stretcher®. This Class 1 Medical Device was specifically designed to help with piriformis syndrome exercises.