Piriformis is a pear-shaped skeletal muscle found below the gluteal muscle which begins in the pelvic cavity and runs through the greater sciatic notch and inserts outside the pelvic cavity. Its passage divides the greater sciatic notch into superior and inferior compartments.
Piriformis syndrome is a condition where the muscles around the buttocks are contracted and cause pain in the sciatic nerve that radiates pain down the leg. Reportedly, 5 percent of sciatica occurs due to piriformis syndrome. Piriformis syndrome and pregnancy relate to one another when the shift occurs in the pelvis.
At the final stages of pregnancy, women experience tightness in the piriformis muscle which contracts the sciatic nerve below it and causes a shift in the pelvis. Bread feeding body releases relaxin, a chemical that relaxes the ligament around the pelvis. Consequently the pelvis shifts and expands leading to stretching and tightening of the piriformis muscle. Change in posture is another aspect that brings together piriformis syndrome and pregnancy.
Piriformis syndrome occurs due to injury, abnormal development or location of piriformis muscle or sciatic nerve, abnormal spine alignment, leg length discrepancy, prolonged sitting, prior hip surgery, unusually vigorous exercise, and foot problems.
Diagnosis of piriformis is done after ruling out other possibilities such as lumbar disc herniation, sacroiliac joint dysfunction. A physical study is done to probe if movement causes increased low back pain or sciatica pain. Medical history is compiled including the positions and activities that influence the symptoms, duration of symptoms, and treatments that were tried.
However, piriformis syndrome does not show in imaging tests such as X-rays, CT scans and MRI.
Pain, tingling and numbness in the buttocks are symptoms of piriformis syndrome. Pain occurs while sitting in the car seat, climbing stairs, applying pressure over the piriformis muscle, and while running.
Squats help patients suffering from piriformis pain during pregnancy to gain strength in the legs and avoid pain in the hip and lower back besides stretching glutes(large muscle of buttocks) and pelvic floor.
Gomukhasana helps to stretch the outer hips and is helpful for those who have tightness in the connective tissue that runs along the outside of the leg from hips to knee and shinbone. Exercises like ankle to knee, pigeon pose, and wide-leg straddle are equally helpful.
Piriformis pain during pregnancy has a bad reputation of disturbing sleep and here’s how the issue could be managed. Since the way one sleeps affects spinal support and invites back pain, the mattress type, pillow use and sleep position must be carefully chosen. Besides these measures, regular stretching exercises would help a patient with piriformis syndrome to sleep well.
The mattress must possess proper support and padding and should be medium-firm and self-adjusting. The mattress is selected according to one’s height, weight and sleeping patterns. Side sleeping is best for pregnant women who must keep their legs straight or only slightly bent. Full bent knees cause uneven distribution of weight. If pain is worse while standing, it is better to sleep in a reclined position in a reclining chair or adjustable bed with wedge pillows.
If you are one of those suffering from piriformis syndrome during pregnancy, Dr Karunakaran is the good news. The best spine surgeon in Chennai with more than two decades of experience in spine care treats not only the above-mentioned issue but also a range of spine-related problems with the aid of state of art modalities and the best skills in the industry.
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