Piriform muscle syndrome is the culprit!
After detailed examination, Mr. Wang was diagnosed as "piriformis syndrome". So, what is this piriformis syndrome that makes Mr. Wang's legs numb and his ass ache? How to treat and prevent it? Today, the team of Professor Lin Dingkun from Guangdong Provincial Hospital of Traditional Chinese Medicine answers your questions.
Expert interpretation
Piriform muscle syndrome is a disease caused by sciatic nerve compression in piriformis area. When piriformis muscle is injured, congestion, edema, spasm, adhesion and contracture occur, the muscle space or the upper and lower holes of muscle become narrower, and the blood vessels and sciatic nerves passing through it are squeezed, which causes a series of clinical symptoms and signs, which is called piriformis muscle injury syndrome.
▲ The sciatic nerve passes under the piriformis muscle. When piriformis muscle is injured and spasms, it will stimulate sciatica and cause sciatica.
What are the manifestations of piriformis syndrome?
Clinical symptoms of 0 1
The main manifestation is hip pain on the affected side, which can extend from the hip to the lower leg and foot through the posterior and lateral thighs, accompanied by numbness, fatigue and limping of the lower limbs. Sitting cross-legged, bending over and lifting weights can all lead to increased pain and numbness. When the pain is severe, there will be painful claudication, severely limited range of motion of lower limbs, and even difficulty in walking. Chronic patients may have gluteal muscular atrophy and limb shortening.
02 physical examination performance
During the physical examination, there will be tenderness in the piriformis area, and the muscles can be felt swollen and stiff. The pain is aggravated when the waist and buttocks are raised and bent. When the patient is supine, the pain is obvious when the straight leg is raised within 60 degrees, and it will be relieved when it is over 60 degrees.
03 disease identification
Piriform muscle syndrome often needs to be differentiated from lumbar disc herniation, lumbar spinal stenosis and neurilemmoma. If the above-mentioned clinical manifestations appear, it is recommended to seek medical advice and conduct relevant examinations in time for further systematic diagnosis and treatment.
Why does piriformis syndrome occur?
The history of trauma is the main cause of piriformis syndrome.
Most patients with piriformis syndrome have a history of trauma, such as sprained hip joint, squatting with heavy objects on their shoulders, walking with heavy loads, catching cold and so on. Local hyperemia, edema or spasm, repeated injury leads to the thickening of piriformis muscle, which can directly compress sciatic nerve, thus causing piriformis syndrome. Some bad habits, such as sitting for a long time, standing for a long time, and crossing your legs habitually, can also cause chronic strain of piriformis muscle.
A small part is due to the behavioral variation of the sciatic nerve when it leaves the pelvis.
In addition, a few patients walk through piriformis muscle because of the behavioral variation of sciatic nerve when it comes out of pelvis. When the hip joint is externally rotated, the muscles contract strongly and the pressure on the sciatic nerve is too great. In the long run, it will lead to chronic injury of sciatic nerve. Furthermore, piriformis syndrome can be seen occasionally in patients who have repeatedly injected gluteus muscle.
How to treat piriformis syndrome?
Most patients can be treated conservatively.
Treatment of piriformis syndrome can be divided into surgical treatment and conservative treatment. Conservative treatment includes manual therapy, local blocking, drug therapy (non-steroidal anti-inflammatory drugs or traditional Chinese medicine for external application and oral administration), acupuncture and so on. Only when conservative treatment is ineffective and the diagnosis is clear will surgery be taken.
Manual therapy is the first choice for piriformis syndrome.
Meridian massage can relax hip muscles, improve muscle mechanics, reduce local compression, effectively improve local muscle and joint inflammation, and create an environment conducive to muscle and nerve repair. The combination of acupuncture and traditional Chinese medicine can promote local blood circulation and relieve local pain, which is an important therapy in conservative treatment of piriformis syndrome.
How to prevent piriformis syndrome?
The best way to deal with diseases is to prevent them before they get sick. If we pay more attention at ordinary times, we can suffer from fewer diseases in the future. To maintain the piriformis, we can start with the following points:
Daily maintenance
Sit up straight: keep a correct sitting posture and don't cross your legs; Avoid sedentary: after sitting quietly for 30 minutes, pay attention to getting up and exercising;
Avoid strenuous exercise: avoid large movements during normal exercise;
Cold and warm: avoid direct air conditioning blowing in summer, and add clothes in time when it is cold to avoid being disturbed by cold.