Piriformis Syndrome is a symptom set that describes burning, tingling, or pins and needles down your leg. This symptom set rarely crosses your knee and can include a sharp pain in your glute, around where your piriformis is located. It is also common to have a decrease in hamstring flexibility due to this condition. This decrease in flexibility is stubborn and does not respond to traditional stretching.
Although commonly thought to be caused by a "tight piriformis" pinning down the sciatic nerve due to your "weak" glutes, the truth is more complicated. In most cases, the nerve is pinned down due to fibrous adhesion in the muscles adjacent to the piriformis. This causes your nerve to tension, instead of glide, through your glutes. As a response to this tension, your brain will tighten up your hamstrings as a protective mechanism.
Because it's not caused by a glute weakness, no amount of glute strengthening will improve this condition. Because the lack of flexibility is secondary to a nerve entrapment, no amount of traditional stretching will help. Interventions should be focused on improving the nerve mobility, using flexibility as a metric of progress.
If you go to a traditional allopathic doctor, they may suggest surgery. You do not need surgery for this condition and a combination of home care, with expert treatment, should do the trick.
First, test out your straight leg raise using this test.
Then, utilize a sciatic nerve floss to improve your nerve mobility. Try that movement every day for 1 minute on each leg, for 4-6 weeks. Re-test BEFORE each session to measure progress. If your range increases or your symptoms decrease, you're on the right track. If you don't see tangible improvement throughout that time, seek professional help.
At Wildcard, we can break up the adhesion surrounding the nerve at both the hip AND the hamstring using Shockwave Therapy or Instrument Adhesion Release. This can take anywhere from 3-8 visits and patients typically see around a 50-75% improvement.
At Wildcard Spine and Sport, we specialize in fixing pain that’s lasted longer than six months, even if you’ve seen two or more providers. We are the only practitioners in the five boroughs certified to diagnose and remove adhesion. Click the button below or call the office today at 917-908-0055.