These exercises can be successfully used to restore normal functioning of the lumbar spine, strengthen the paravertebral corset, improve coordination of various segments of the spinal column and stretch the spasmodic piriformis muscle.

In some cases, the cause of pinching of the sciatic nerve is spasm of the m.piriformis. The disease is called - piriformis syndrome. The piriformis muscle (m.piriformis) is attached to the sacrum and femur, and, like any muscle, it can shorten and become tense. The piriformis muscle passes under the gluteal muscle and over the sciatic nerve. Its function is to keep the knee and foot turned forward when walking, and it also plays a modest role in hip abduction.

About sciatic nerve disease

Pinching of the sciatic nerve by the spasmodic piriformis muscle can lead to its inflammation, which is associated with the spread of pain along the back of the leg of the same name.

Pain usually occurs: from hard work, excessive exercise in the gym, long running, prolonged sitting, as well as from various injuries and wounds.

There is local pain on deep palpation in the center of the buttock with reproduction of numbness, parasthesia (numbness, tingling sensation, crawling) in the lower leg, foot and buttock in the area of ​​innervation of the sciatic nerve.

Blocking the piriformis muscle with novocaine significantly alleviates the condition. The Bonnet symptom is positive - increased pain in the prone position when the leg is bent at the knee joint (V.F. Kuznetsov, 2004).

Piriformis syndrome can be confirmed by symptoms, as well as with the help of MRI (tomography can show a depleted or overstrained piriformis muscle), there is also a new neuroimaging method.

What causes piriformis syndrome?

• Weak gluteal muscles As a result, the load on the piriformis muscle increases.
• Subluxation in the hip and sacroiliac joint, which places additional stress on the piriformis.
• Rolling of the foot (ankle) inward when walking, again, overuses the piriformis muscle.
• Pinched nerve root at the level of the first sacral vertebra leads to pathological tension of the piriformis muscle.
• Trauma (severe bruise, wound), which can lead to muscle tearing (in this case, yoga exercises to stretch the muscle may be ineffective).

How can exercise help?

• First, gently stretching the tight muscle will help it relax.
• Secondly, improve blood circulation in the area where the sciatic nerve is pinched.
• Thirdly, help achieve general relaxation, which will lead to partial muscle relaxation.
• Fourth, improve the functioning of the sacroiliac joint and hip joints.

It should be noted that these exercises are of an auxiliary nature. It is necessary to receive comprehensive treatment from a neurologist and use exercises only as an important addition.

Manual therapy, particularly PIR (Post Isometric Relaxation), can help relax a spasmed muscle.

Surely massage of the affected buttock, or self-massage using rolls on a tennis ball, is positive.

Exercises for Piriformis Syndrome

I would like to note that all exercises must be done slowly and carefully; if possible, be sure to attend classes with a qualified instructor so that you understand how to perform the exercises. Breathing should be calm and slow, without delay. You need to breathe through your nose.

Do not do exercises if you have sore knees, hip joints, after operations during which physical exercise is prohibited, or if you are pregnant.

It should be added that pinching of the sciatic nerve can be provoked by “shorting” of the nerve roots at the level of the lumbar vertebrae.

Exercise 1

• Sit on a mat or mat and straighten your legs. Alternately, stretch your buttocks back with your hands and sit on your sit bones. Bend your right leg at the knee and place it next to the knee of your left leg.
• Inhale and extend your left arm vertically upward. Exhale, place the elbow of your left hand behind your right knee, and extend your right hand back and place it on your fingers on the floor behind your back.

Keep your back straight! The shoulder girdle is parallel to the floor. Look directly behind your left shoulder. There should be no pain.

• Perform twisting for 15-20 deep breaths. With an inhalation, return to the starting position, rest, change legs and twist in the other direction.

To better stretch the piriformis muscle, the foot of the bent leg can be moved behind the straight knee.

Exercise 2

• Sitting on the mat, bend your left leg and place your heel next to the hip joint of your right leg, placing the foot of your right leg behind the knee of your left.
• Inhaling, extend your left arm up, exhaling, place your palm behind your right knee, turn your head and look directly behind your left shoulder.
• Maintain a comfortable position for 15-20 calm breaths. Keep your attention on general relaxation.

Several positions of the left hand are possible:

• the simplest thing is to place your palm on your right thigh,
• a more difficult option is to place your elbow behind your knee,
• another option - with your elbow in, move your palm to the hip joint of your right leg,
• the next one is to move your hand to your right foot and grab onto it,
• another one is to clasp your right knee with your left hand, place your right hand behind your back and lock your fingers.

Do the option in which you can relax.

Perform the position by switching legs and arms in the other direction.

A mirror will be a good help in practice. If possible, do the exercise in front of a mirror.

Exercise 3

These exercises can be successfully used to restore normal functioning of the lumbar spine, strengthen the paravertebral corset, improve coordination of various segments of the spinal column and stretch the spasmodic piriformis muscle (Musculus piriformis).

• Lie stretched out on your back, spread your arms to your sides at the level of the shoulder girdle. Bend your knees, placing your feet slightly wider than the width of your pelvis.
• As you exhale, point your knees to the right side, maintaining a comfortable state, without pain. With an inhalation, raise your knees to the starting position and, as you exhale, repeat in the other direction.

Pay attention to avoid pain in your knees, hip joints, stomach and back.

A similar exercise, only with fixing the position of the abducted knees for 10-15 calm and deep breaths. This option is suitable for stretching the iliopsoas muscle.

If holding your knees abducted causes discomfort, then place a stack of books or other similar object under them. Straightening the upper leg to the side and placing it on the floor or on a support will promote extension of the piriformis muscle, which can be used when the sciatic nerve is pinched by the piriformis.

To stretch the piriformis muscle, do an exercise with twisted legs. Lie stretched out on your back, bend your knees, and “wrap” your right leg with your left leg. As you exhale, point your legs to the right side and stay in a comfortable position for 10-15 calm and deep breaths. With an inhalation, raise your legs to the starting position, change the cross of your legs (now the right leg goes over the left) and perform a similar twist in the other direction.

Exercise 4

The exercise is difficult, especially for beginners.

• Take a chair. Stand so that you can rest your hand on a chair.
• Place your right foot along the mat, and turn your left foot at 45 degrees and place it a little more than a meter from your right (heels in line or slightly apart for stability).
• Exhale, lower your left hand to the chair, raise your right hand up and look at your right palm. The higher the stand under your left hand, the easier it will be to perform the exercise.
• Perform exercises without pain!
• Stay in the exercise for 15-20 calm breaths. Concentrate on general relaxation.
• With an inhalation, rise up and perform the exercise on the other side, switching arms and legs.

When performing the exercise, a diagonal stretch of the piriformis muscle occurs.

Exercise 5

This is also a difficult exercise and to perform it you need to prepare two chairs. Place the chairs so that you can rest your palm on one and the toes of your outstretched foot on the other.

• Place both palms on one chair and your straight left leg on the other.
• With an inhalation, slowly raise your right hand up, looking at your palm. Stay in the exercise for 15-20 calm breaths.
• Exhale, lower your right hand to the chair, switch legs and twist in the other direction.

When performing the exercise, the piriformis muscle is stretched in a horizontal plane.

Exercise 6

• Sit on the mat with your left leg bent and your right leg extended back. Make sure that your pelvis is turned forward. If your pelvis collapses, place a folded blanket under your left buttock.
• Take stacks of books or other similar objects and place them on either side of your pelvis.
• Try to keep your back vertical; if you experience discomfort in the lower back, then move the objects a little forward so that your back bends. This will help remove tension from your lower back.
• Pay attention that there is no pain in the hip joints and knees! Try to relax your legs, concentrate on general relaxation.
• Hold the exercise for 15-20 breaths. Then slowly switch legs and repeat the exercise.

Exercise 7

Heel to knee exercise.

• Sit on the mat. Bend your right leg slightly.
• Then slowly bend your left leg and place your heel towards your right knee. If you bend your right leg too much, then when you turn the heel of your left leg, there may be unpleasant sensations in the knee joint that should be avoided. If you experience discomfort in your knee, straighten your right leg slightly.
• Place your palms behind your back and begin to slowly push your chest toward your left leg with your hands.
• Observe that there is no pain in the knee. Try to direct relaxation to the left buttock area with each exhalation.
• Perform the exercise for 15-20 breaths.

As a result of this exercise, the muscles of the buttocks, including the piriformis, are stretched.

Possible options for the heel to knee exercise are sitting on a chair and lying on your back.

Exercise 8

Exercise strap on the foot, leg to the side. Prepare a strap (you can take a towel, belt or tie).

• Stretch out as shown here and lie down on your mat.
• Take the strap in your left hand, bend your right leg and place the strap over your heel.
• Straighten your leg, adjust the length of the strap so that there is no pain in the back of the leg.
• Exhale and point your right leg to the left.
• If there is no discomfort in the buttock, then the foot of the right leg can be lowered to the floor; if there is, then lower the leg on a stand (chair, etc.) so that there is no pain in the buttock.
• Inhaling, lift your right leg, bend it and lower it to the mat.
• After resting, repeat the same with your left leg to the right side.

Exercise 9

Prepare a stack of books or other items.

• Sit on the mat with your legs crossed.
• Lean on your palms and kneel down. Bring your knees as close as possible (one knee on top of the other) and point your heels to the sides.
• Helping yourself with your hands, sit on the floor (or on an object). There should be no pain.
• Hold the exercise for 15-20 calm breaths.
• Then perform with the other leg on top.

Exercise 10

• Lie on your back motionless. This position eliminates the fatigue that appears after other exercises and calms the emotions.
• Stretch out as shown here and lie on your back. Relax completely. Observe the incoming and outgoing breaths.

Start the duration of the exercise with 5 minutes and complete the set of exercises with relaxation for 15-20 minutes.

• Do those exercises that do not cause pain and work well.
• If you are unable to do any exercise or feel pain, then skip it.
• If you are a beginner, it is better to take several individual lessons or consultations with an experienced instructor. published .

P.S. And remember, just by changing your consumption, we are changing the world together! © econet

Pain localized in the buttocks, which can also radiate to the groin, thigh and lower leg, is called piriformis syndrome. The cause of pain in this area can be injury, muscle strain, hypothermia, incorrect administration of the drug, muscle tension, etc.

Symptoms of this syndrome may include local manifestations, as well as symptoms caused by compression of the sciatic nerve or blood vessels.

Piriformis syndrome: how to suspect a disorder

Symptoms that indicate the presence of piriformis syndrome include:

• nagging or aching pain in the buttock area, which can radiate to the pelvis or leg and intensify during walking and prolonged standing;
• the piriformis muscle can be felt by relaxing the muscles of the buttocks;
• pain in the back of the leg when tapping the piriformis muscle;
• pale skin on the leg;
• periodic spasms of blood vessels in the leg, etc.

The doctor will be able to accurately determine the presence of a piriformis muscle symptom after an examination.

Causes of piriformis syndrome:

• spinal injury;
• hypothermia;
• problems in the sacroiliac joint;
• injuries;
• lumbar stenosis;
• failed injections;
• muscle overtraining.

Exercises to relieve pain from piriformis syndrome

The best decision you can make if you suspect piriformis syndrome is to consult a specialist. After confirming the diagnosis, he will prescribe a treatment package, which may include:

• drug therapy (painkillers);
• massage;
• physiotherapy;
• exercises;
• vacuum therapy;
• acupuncture.

To avoid worsening your condition, the site recommends that you strictly follow the recommendations of your doctor.

Stretching exercises to help with piriformis syndrome

Given the location of the piriformis muscle, we can conclude that static stretching is advisable. It is important to perform actions carefully, without sudden movements and, of course, daily.

1. Outer thigh stretch

Lie on your back and bend one leg at the knee. With the opposite hand, grab your knee and move it to the extreme point, as shown in the figure. Hold your knee for 20-30 seconds. Repeat the steps 3-5 times (preferably three times a day).

1. Piriformis stretch

Lie on your back. Bend both knees, placing both feet on the floor. Place the outer edge of the foot of the leg that you are going to stretch approximately at the level of the knee of the other leg. With your hands, grab your thigh (see picture) and pull your knee towards your chest. You should feel the stretch in your buttocks. You need to stay in this position for 30 seconds and repeat 3-5 times (3 times a day).

1. Adductor longus stretch

Sit on the floor. Keep your back straight. Spread your straight legs to the sides as far as possible. As you exhale, bend forward. After 30 seconds, return to the IP.

1. Adductor brevis stretch

Sit on the floor. Bring the soles of your feet together. Using your elbows, apply gentle pressure to your knees to properly stretch the muscles. You should feel a slight stretch on your inner thigh. Duration of stretching is 30 seconds, number of repetitions is 3-5 times.

Exercises to Strengthen the Piriformis Muscle

1. Exercise with an expander

Fix one end of the expander around the ankle, the other - on a stationary object near the floor. Move your leg to the side without bending your knee. After reaching the maximum point, slowly put your foot back. Repeat 15 times. Do 2 sets.

1. Lying on your side

Lie on your side with the thigh you will be working on on top. Bend your knees and place them so that your feet are in line with your spine. Keeping your ankles together, lift your top knee up. The back and pelvis remain motionless - all movements come from the hip. Repeat 15 times. Do 2 sets.

1. Hip stretch

Get on all fours. Shift your weight away from the leg you will be working on. Without straightening your leg at the knee, lift it off the floor so that the sole of your foot points upward. Slowly lower your leg almost to the starting position. Repeat 15 once. Do 2 sets.

Stretching exercises will help relieve piriformis syndrome, and strengthening exercises will reduce the risk of the problem recurring. However, the site reminds that before performing stretches and exercises, you must obtain confirmation of the diagnosis and permission from a doctor.

The piriformis muscle belongs to the group of internal pelvic muscles. This is the only muscle formation that connects the bones of the iliosacral joint. Anatomically, it has a triangular structure and is attached by tendons to the pelvic bones. The muscle is attached at one end to the lateral surface of the sacrum, enters in bundles into the hole between the 3rd and 4th sacral bones, then extends beyond the small pelvis through the greater sciatic foramen and is attached by a tendon to the top of the greater trochanteric bone. In addition to muscle fibers, vessels that supply blood to the pelvic structures and nerve bundles pass through the hole.

Functions of muscle formation:

• the muscle is responsible for the movement of the pelvis;
• together with other muscle groups, it is involved in hip rotation;
• participates in abducting the hip to the side when bending the leg at a right angle;
• stabilizes the hip joint;
• holds the femoral head in the socket of the pelvic bone;
• responsible for the forward tilt of the sacrum.

Since the piriformis muscle plays a large role in holding the pelvic bones, with any dysfunction in this area it experiences overstrain. Clinically, this is much more pronounced than in any other short thigh muscle. Experts combine the symptoms of inflammation into one diagnosis - piriformis syndrome.

The piriformis muscle is located under the largest muscle of the body - the gluteus, and next to it runs a ligament that connects the ends of the sacral processes. In the sciatic foramen, between the body of the piriformis muscle and the ligament, there are blood vessels that supply the short muscles of the thigh and the nerve itself. If inflammation occurs in the piriformis muscle as a result of fatigue or other reasons, the lumen of the opening narrows and ischemia of the sciatic nerve appears. The person experiences excruciating pain and other symptoms.

Thus, piriformis syndrome occurs:

• when a nerve is pinched by an inflamed muscle in the hole itself;
• when the sciatic nerve passing through the piriformis muscle is pinched;
• when there is compression of the nerve processes of the sacral region - the genital, posterior cutaneous, and lower gluteal.

Pain and inflammation only increase spasm of the piriformis muscle. This occurs due to the fact that, together with the sciatic nerve, the artery that feeds it is compressed, which disrupts trophism and metabolism in muscle tissue cells.

Piriformis syndrome can be caused by a variety of reasons. The main ones:

• chronic fatigue and stress;
• poor nutrition;
• uncomfortable body position for a long time;
• hypothermia;
• lack of microelements in the pelvic bones;
• stretching;
• hematoma;
• pelvic trauma;
• tumor process in the radicular zones of the spinal cord;
• incorrectly placed intramuscular injection;
• advanced osteochondrosis of the lumbar and sacral region.

Experts distinguish between primary and secondary piriformis syndrome. All of the above reasons cause primary inflammation, the secondary one is due to the fact that the inflammatory process spreads to the piriformis muscle from the junction of the ilium and the sacrum and from organs located in the pelvis.

Statistically, piriformis syndrome is rare. It equally affects people of different ages and genders - teenagers and pensioners, men and women. Anyone who plays sports, regularly trains in the gym and experiences severe muscle strain needs to be aware of the symptoms of this disease.

Piriformis muscle syndrome cannot occur in a latent phase; it always has pronounced symptoms, which consist of local signs, symptoms of ischemia or neuritis of the sciatic nerve, manifestations of atrophy due to compression of the vessels innervating the nerve and the inferior gluteal artery. Symptoms of local inflammation include the following:

1. A sharp pain appears in the pelvic area, which intensifies in an upright position of the body, when walking and when moving the hip inward. If you lie down or sit with your legs wide apart, it subsides a little.
2. The pain is dull, aching, twitching, sometimes shooting and burning, especially at night when it is warm and when the weather changes.
3. The sciatic nerve is one of the largest nerve plexuses in the body. It innervates the pelvis and lower extremities. With neuritis (pinching) of the sciatic nerve, pain can spread over the entire surface of the thigh, cover the buttocks area and go down to the heel bone and toes.
4. Along the course of the nerve, the patient may experience unpleasant sensations - tingling, a feeling of numbness.
5. In the affected areas of the pelvis and leg, sensitivity decreases; the patient does not feel needle pricks and does not withdraw the limb when it comes into contact with a hot object.
6. Pain occurs not only when walking, but also when trying to change the position of a limb, as well as when crossing legs.
7. Sometimes inflammation spreads to the pelvic organs, in particular to the bladder, which can cause problems with urination.
8. Compression of the vessel causes lameness, while the skin in the buttock area becomes pale due to poor blood supply.

Symptoms of sciatic nerve ischemia:

1. The pain is pressing in nature. They are accompanied by vegetative symptoms - chills, burning sensation and stiffness.
2. The pain is localized mainly in the area of ​​innervation of the tibia and fibula; it intensifies with walking and palpation of the lower leg muscles.
3. The Achilles ligament reflex and skin sensitivity are reduced.
4. Unpleasant sensations and pain are provoked by stress, weather changes, and excessive heat.

Symptoms of compression of blood vessels and the inferior gluteal artery:

1. Vascular spasms in a vertical position, lameness when walking, which disappear when changing body position - sitting or lying down. The attacks are repeated.
2. Paleness of the skin of the buttock and affected limb.

If symptoms of the disease appear, you should consult a doctor. It requires professional diagnosis and treatment depending on the causes.

A set of diagnostic examinations is carried out to differentiate inflammation of the piriformis muscle and other diseases with similar symptoms - arthritis, osteochondrosis, hernia of the lumbar and sacral spine, damage to the iliosacral region and other inflammatory processes affecting the pelvic area.

The doctor makes the primary diagnosis of piriformis muscle syndrome based on external examination. The following manual tests are recorded on the patient:

1. In a sitting position, the patient experiences discomfort and is forced to change position; he has difficulty throwing the affected leg onto the healthy one.
2. Checking muscle strength: the patient lies on his back, the doctor puts his hands on his knees and asks him to spread his legs through resistance. On the affected side there is colic and rapid muscle fatigue to the point of trembling.
3. Bonnet syndrome: the patient lies on his healthy side and bends the leg at an angle of 90°; with a relaxed buttock, a seal is palpated on the outside - a spasmodic piriformis muscle. Pain is recorded in the area of ​​the sciatic foramen and along the entire length of the muscle.
4. Tests with provocation: the patient lies on his back, the doctor turns the thigh outward and inward, notes whether there is pain, whether mobility is limited, how the pain spreads along the sciatic nerve. When straightening the leg, shortening of all muscle groups responsible for turning the thigh outward is recorded. When bending the leg, shortening of the muscle fibers is observed. When you move your leg to the side, pain, weakness and a feeling of numbness appear.
5. Vilenkin's symptom: tapping the muscle causes pain in the pelvic area, spreading to the back of the thigh.
6. Grossman's symptom: when tapping the iliac bones, the pain radiates to the buttocks.
7. In complex and controversial cases, rectal or vaginal examinations are used; they are recognized by experts as the most informative diagnostic method. The patient lies on his side, the leg is bent at the knee, the doctor palpates the piriformis muscle, noting its soreness and spasms. Pain is also recorded during a digital examination of the muscles, ligaments and pelvic organs; when raising a bent knee, an increase in the volume of the muscle body is determined.

The final diagnosis is made based on data from other types of diagnostic examinations.

An important diagnostic test is the injection of novocaine drugs into the piriformis muscle. After the blockade, the patient notes a weakening or complete disappearance of painful symptoms. They are not noted during manual tests either.

Instrumental methods in diagnosing the condition of the piriformis muscle are practically not used, since criteria have not been developed that make it possible to clearly name the degree of pathological changes, and the norms for the relationship of the muscle with the vessels and nerve intertwinements in the buttock area have not been determined. This is due to a number of anatomical features:

• the piriformis muscle is covered by the thickness of the buttock, so examination with a myograph does not give results; ultrasound examination is difficult due to the large intestine, which passes over the area of ​​inflammation;
• With piriformis syndrome, large and medium-sized arteries are not affected, so Doppler ultrasound is not used.

True, in 2004, a group of scientists from the Russian State Medical University proposed a new diagnostic method using Doppler ultrasound. To do this, blood flow indicators are taken in the first phalanx of the thumb on the diseased and healthy side. The amplitude of blood flow on the affected side decreases by 30-50%. The method is used not only for diagnosis, but also to evaluate the effectiveness of treatment.

An echographic examination of the sciatic nerve provides some information. To do this, an echography is performed on the healthy and diseased sides in order to be able to compare the results. Changes in the diameter of the nerve and increased blood flow are recorded, which indicates the presence of inflammation. Sonography does not harm the body, so it is recommended to evaluate the results during the course of treatment.

CT and MRI can exclude tumor formations that create pressure on the sciatic nerve, sacral plexus and blood vessels. MRI allows you to assess the degree of muscle damage in the acute and subacute period of the disease. The image clearly shows swelling, infiltration and atrophy of the inflamed muscle. MRI is increasingly used in modern diagnostic practice, as it shows the degree of obstruction and stenosis of vessels pinched by the muscle.

If there is a need to distinguish piriformis muscle syndrome from pinched sacral nerve roots or herniated vertebral discs, magnetic resonance imaging is performed with the injection of a contrast agent into the gluteal arteries. This method allows you to record:

• increase in muscle size;
• changing the direction of its fibers;
• change in anatomical structure.

After making a final diagnosis, the doctor prescribes treatment. As a rule, it is complex and consists of several components:

1. Drug therapy.
2. Massage.
3. Physiotherapeutic treatment.
4. Corrective treatment (insoles, buttock pads, etc.).

Drug treatment:

1. Anti-inflammatory drugs. The basis of drug therapy is drugs from the group of anti-inflammatory non-steroidal drugs. The most effective drugs based on diclofenac have proven themselves - Voltaren, Dicloberl, Diklo-F, Meloxicam, Ketanov, etc. Depending on the degree of development of the disease, they are prescribed orally or intramuscularly. The course of treatment is at least 10 days, 2 injections of the drug are given daily with a period of 6 hours.
2. If the patient is in pain, painkillers and antispasmodics are prescribed. They relieve muscle spasms well, reduce pressure on the sciatic nerve and surrounding vessels. Suitable painkillers include: Baralgin, Tempalgin, Sedalgin, etc. The most commonly used antispasmodics are No-Shpa, which is administered intramuscularly along with anti-inflammatory drugs.
3. If the inflammatory process is complicated by bone deformation, then antispasmodics cannot fully relieve the painful spasm. In this case, muscle relaxants are prescribed. They effectively relieve tone from inflamed muscles, freeing pinched nerves and blood vessels. Most often, doctors prescribe Mydocalm.
4. Drug therapy may include drug blockades. When inflamed, the piriformis muscle becomes painfully stretched and compressed, and the roots of the sacral region are involved in the process. The purpose of the novocaine blockade is to relieve spasm and tension from these pelvic structures. The doctor marks the points of the ischial tuberosity, ilium and greater trochanter, connects these marks and determines the area of ​​drug administration. Then he inserts the syringe needle to a depth of 6-8 cm and slowly releases novocaine into the space between the muscle body and the sacral root. The adult dose for blockade is 10 ml.

Pathologies of the piriformis muscle are quite difficult and lengthy to treat. Therefore, the drug course is repeated at least 2 times a year during seasonal exacerbations.

Massage and muscle stretching can relieve painful tone, improve vascular trophism, speed up metabolic processes in myofibrils, and remove discomfort when walking and sitting. Massage of the piriformis muscle includes several directions:

1. Self-massage.
2. Rectal massage.
3. Stretching and relaxation.

The patient can perform self-massage regularly. No special devices are needed for this. All you need is a flat and hard surface. It is best to perform self-massage movements on the floor.

To eliminate the effects of compression of the sciatic nerve, you need to lie on your side and carefully massage the area of ​​the gluteal muscle with your thumb, trying to pay more attention to painful and compacted areas. The massage will be more effective if the muscle is in a slightly stretched state; for this you need to bend the leg at the knee joint.

Self-massage of the piriformis and other short muscles involved in hip rotation using a tennis ball is carried out on a flat, hard surface (a prerequisite). The patient lies on his side and slides the side surface over the ball. The ball must touch compacted and painful areas; the places where the sciatic nerve passes are avoided so as not to increase its ischemia. Movements should be slow, smooth, sliding and directed downward (in the direction of the muscle fibers). If there is a feeling of numbness or tingling, then the ball has hit the sciatic nerve. In this case, it needs to be moved a little forward. One session includes at least three rolls.

Rectal massage is performed by a specialist. The patient lies on his side, the doctor inserts a finger into the patient’s rectum, finds the area of ​​painful compaction of the piriformis muscle and begins to lightly massage the spasmodic areas. As you massage, the pressure either intensifies or weakens. Rectal massage is a highly effective procedure that allows you to quickly relieve ischemia of muscle fibers and the sciatic nerve.

For stretching and relaxation, exercises are performed by a doctor who controls the strength of turns and pressure. The main condition is that the patient must feel a pleasant tension in the muscles, pain is unacceptable. Exercises are carried out in the hip joint and along the entire length of the leg to the heel bone. The technique is based on overcoming light resistance, stretching inflamed areas and decompression in areas of spasm.

Manual therapy is an alternative non-traditional method of treating pathologies associated with the spine and muscles. It is performed by an osteopathic doctor with extensive experience and proven techniques. Its task is to relieve disturbing symptoms and restore full range of movement in the affected joint.

The patient should carefully consider the choice of a specialist; it is worth finding a clinic with a good reputation where they can provide stable remission.

When piriformis syndrome is treated, physiotherapeutic procedures cannot be avoided. Warming procedures using low-frequency electric currents give a good effect:

• electrophoresis:
• phonophoresis;
• amplipulse;
• exposure to dynamic currents.

In the treatment of inflammation of the piriformis muscle, vacuum massage is used, and recently innovative laser treatment methods are used.

The unique methods of ancient oriental medicine are firmly entrenched in modern practice of treating diseases associated with inflammation and muscle spasms. Reflexology is a general concept that combines a number of techniques:

• acupuncture;
• blockade;
• finger impact on active points of the body;
• cauterization and warming of active points;
• exposure to laser and electrical impulses;
• work with active points on the auricle;
• point-linear massaging.

The methods are applied individually, based on the symptoms and stage of development of the disease.

The complex includes several simple exercises that will help relieve disturbing symptoms and alleviate the general condition during the period of inflammation of the piriformis muscle. The complex is performed on the floor in loose clothing and in a relaxed state. Exercises should not cause pain or discomfort. If pain occurs, you should consult a doctor.

1. Lie on your back and bend your knees slightly. Slowly bring your knees in and out, trying to stretch the muscles.
2. Sit down with your legs crossed. Sit in this position for 5 minutes, then change legs.
3. Sit on a stool with your legs at a 90° angle. Stand up, trying not to spread your knees, straighten up, relax your knees.
4. Sit on a stool, cross your legs. Slowly lie down with your body on the leg on top 5-10 times. Repeat the exercise with the other leg.
5. Get on all fours. Slowly straighten your leg and try to stretch the muscles of the hip joint as much as possible, stretching your toes. Repeat with the other leg. Do 3 approaches.
6. Lie on your back, straighten your leg up and move it in the opposite direction, trying to reach the floor. You should feel a springy stretch. Repeat with the other leg. Do 3 approaches.
7. Lie on your stomach, legs together. Actively push one knee with the other for 5 seconds. Do the same with the other knee.
8. Lie on your back, spread your arms to the sides, raise your legs and bend your knees. Move your legs in the opposite direction (to the maximum), trying not to lift your shoulder blades off the floor. Repeat 5 times in both directions.

It is advisable to repeat the complex several times during the day to ensure the desired effect.

You can do physical therapy with a professional trainer who will select the right load and teach you how to breathe correctly.

The famous doctor, Doctor of Medical Sciences, Professor S. M. Bubnovsky is the author of several unique techniques that help cure many pathologies of the musculoskeletal and muscular system, as well as restore their lost functions.

Bubnovsky combined the best experience of orthopedists and neurologists; his system is based on a deep knowledge of the anatomy of the human body and helps to awaken the body’s internal reserves.

Kinesitherapy by Bubnovsky includes:

1. Assessment of the condition of the skeletal and muscular systems, which allows you to determine the exact localization of the inflammatory process and prescribe treatment based on the nature of the disease, the individual characteristics of the patient and concomitant diseases.
2. Treatment on special simulators at Dr. Bubnovsky’s centers. A course is selected for the patient and the maximum payload is determined. Treatment using simulators eliminates radicular syndrome of inflamed muscles, relieves pain and discomfort, and restores joint mobility.
3. A special course of therapeutic exercises that can be performed quite successfully at home. Let's look at it in more detail.

Gymnastics from Professor Bubnovsky:

1. Get on all fours. Relax your back and hold the position for 5 seconds. Repeat 5-6 times.
2. In a position on all fours, bend your back as you inhale, and slowly bend your back as you exhale until you feel a stretch in the muscles. Perform 20 times.
3. In a position on all fours, sit on your left leg, take your right leg back, fix your step, extending your left arm forward. Slowly change legs, moving forward with such stretching steps, not forgetting to change outstretched arms. Do 20 exercises.
4. In a position on all fours, fix your position with your knees and palms towards the floor. Pull your body forward without lifting your knees and palms from the floor. Make sure that your lower back does not bend.
5. In a position on all fours, bend your arms at the elbow joint, and while exhaling, lower your buttocks onto your heels, trying to stretch the lumbar muscles. Inhale and as you exhale return to the starting position. Repeat 6 times.
6. Lie on your back, put your hands behind your head, bend your knees. Inhale and as you exhale, press your chin to your chest, lift your shoulder blades off the floor and touch your elbows to your knees. It is important that the abdominal muscles are tense until a burning sensation appears. Repeat 5 times.
7. Lie on your back, stretch your arms along your body, while exhaling, try to lift your pelvis off the floor as much as possible, and while inhaling, lower yourself back. Perform from 10 to 30 times.

The complex should be mastered gradually, adding a new exercise every day. Try to do everything with full dedication and good stretching.

Alternative medicine

Of course, a doctor should treat this complex muscle pathology. Treatment methods with folk remedies can only enhance the effect of taking medications and speed up the healing process.

Heat compresses are most often used to treat muscle pain. Here are some of the recipes:

1. Melt a plate of beeswax in a water bath and prepare St. John's wort or burdock oil. Apply oil to the sore spot and then apply beeswax with a wide brush. It is applied in layers as each stroke hardens. The more layers, the longer the compress will give off its heat.
2. Compress of black radish and horseradish. Take a small tuber of black radish, grind in a blender with 1 horseradish root, add 1 tbsp. l. salt and 1 tbsp. l. vinegar. Leave the mixture in a dark place for a week. Fold the gauze in several layers, apply the mixture on it and apply it to the sore spot for 20 minutes. The compress has a local irritant effect and causes a rush of blood.

Rubbing with alcohol has also traditionally been used for muscle pain. They are easy to make, warm the sore spot well and remove decay products, enhancing tissue metabolism.

To rub, take a bottle of Triple cologne, mix it with the contents of small bottles of tincture of valerian and hawthorn, add tincture of hot pepper and 10 crushed tablets of acetylsalicylic acid. Mix everything, put it in a dark place and leave for a week. Rub the sore spot, and to enhance the effect, cover it with compress paper and a warm scarf.

Pain in the buttocks, gradually spreading to the legs, sometimes occurs after an unsuccessful injection or due to the development of pathologies of the pelvic organs. One such disease is piriformis muscle syndrome (PMS). It occurs quite often, and the main problem of this disease is the difficulty of diagnosis. After all, the pain is generally intermittent and manifests itself only in a certain position of the leg. Despite this difficult task, spasm of the piriformis muscle should be identified when the first symptoms appear in order to relieve compression from the sciatic nerve. In this case, the nerve pathways will quickly recover, and the discomfort will soon pass.

It is difficult to understand the features of this syndrome without knowing where the piriformis muscle is located. You can see its location in this image:

Judging by the picture, the piriformis muscle has the shape of a triangle and is attached to the sacrum bone. The path of this muscle tissue passes through the sciatic foramen into the tendon, which is fixed to the trochanter of the femur. The piriformis muscle tissue serves to abduct and return the hip to its original position.

Passing through the sciatic foramen, the muscle tissue leaves room for the artery and sciatic nerve. However, if the muscle becomes tight or is subjected to sudden compression, compression of the nerve pathway is possible. In this case, we are not talking about the radicular nature of the pain, since the root is located much higher.

Signs of compression

Piriformis muscle syndrome has symptoms characteristic of this type of inflammation and from them you can understand how to relieve the spasm. However, the signs of this pathology often differ, because compression can occur not only with the nerve, but also with the artery that supplies it. The main manifestations of inflammation of the piriformis muscle are as follows:

Sometimes the problem also affects the infrapiriform area. In this case, the following manifestations are added to the basic symptoms:

• Aching pain in the legs;
• Worsening discomfort during stress, climate change, etc.;
• Pain in the lower leg after a long walk;
• Mild numbness of the skin.

Causes

Piriformis syndrome differs from radicular syndrome in the localization of compression and the causes of development. The similarity of these 2 diseases lies in the main factor influencing their occurrence, namely overload. Among other reasons, the most basic ones can be identified:

• Prolonged exposure to cold;
• Back injuries;
• Pathological processes in the sacroiliac joint;
• Stenosis in the lumbar region;
• Incorrectly given injection in the gluteal region;
• Diseases of the female genital organs;
• Damage to the gluteal muscles.

Diagnostics

It is quite difficult to understand that it is the pyriform muscle tissue that compresses the neurovascular bundle. Many patients characterize their pain sensations as unstable. They occur mainly in certain positions of the leg or after a long walk.

A doctor can identify piriformis syndrome using special manual tests, for example, palpation of the muscles localized in this area. Feeling the damaged area allows you to identify compaction of muscle tissue. In some cases, novocaine blockade, CT or MRI and x-rays are used for diagnosis.

A detailed interview with the patient can help the neurologist. After all, it is important to find out where it all began. If you have recently suffered an injury in this area, this may indicate the possible presence of pathology.

Course of therapy

Piriformis syndrome is eliminated in the same way as radicular compression and for this it is necessary to relax the muscle. If there are factors that prevent you from doing this, you will have to eliminate them. While carrying out the main part of the course of therapy, the doctor will have to alleviate the patient’s general condition. For this, symptomatic treatment is used, for example, blocking the damaged nerve, taking analgesics, etc.

If the piriformis muscle is very painful, then it should be treated medicinally using such groups of drugs as:

• Muscle relaxants;
• Antispasmodics;
• Analgesics;
• Medicines that improve blood circulation;
• Non-steroidal anti-inflammatory drugs;
• B vitamins.

It is advisable to combine drug therapy with other methods to relieve muscle spasm:

• Massotherapy;
• Acupuncture;
• Physiotherapy methods;
• Physiotherapy;
• Laser puncture;
• Vacuum therapy.

By combining several techniques, it will be possible to speed up the restoration of nerve pathways, relax muscles and alleviate the patient’s condition. However, an experienced specialist should create a set of exercises and perform massage, as this can greatly harm your health.

Massage

Massaging muscle tissue allows them to relax and improves blood circulation and nerve patency. That is why therapeutic massage is often an indispensable component of a course of therapy for spasm of the piriformis muscle. They usually begin to warm up the paravertebral muscles and gradually move towards the lumbosacral region. A massage should be performed by an experienced specialist and only after identifying the cause of the pathology, as it can aggravate its course.

The duration of the procedure usually does not exceed 20 minutes and it is advisable to attend at least 15 massage sessions. In this case, it will be possible to achieve a visible effect and relieve tension from the piriformis muscle.

Exercise for SDM

For piriformis syndrome, exercise is the mainstay of therapy. Thanks to them, you can improve your general condition, normalize blood circulation and relieve tension. You can do physical therapy without leaving your home, but it is recommended to spend a couple of sessions under the supervision of a doctor in order to know the correct technique for performing the movements.

Exercises to relieve spasm from the piriformis muscle are as follows:

• The patient should lie on the floor and bend his legs at the knee joints, and place his feet shoulder-width apart. Next, the lower limbs are separated and brought together at the knees;
• Remaining in this position, you need to put your feet together, and then bend your knees connected together to the right and left. The exercise should be performed smoothly and carefully;
• To perform this exercise, you need to get on all fours. The injured limb should be bent at the knee and set aside. Then this leg must be slowly straightened and returned to its original position. The same action is performed on the other limb;
• Sitting on a chair, you need to straighten your back and place your legs straight. Next, you should place the sore limb on your healthy knee and reach for it with your whole body. In this case, you need to try not to hunch your back and after bending, change your leg.

When doing exercises to relax the piriformis muscle, you need to strictly follow the correct technique. It is advisable to learn about all its nuances from your attending physician.

With piriformis syndrome, a person feels severe discomfort. However, sometimes the pain is inconsistent, so many people delay visiting a doctor. This behavior is erroneous and should be urgently examined when the first symptoms are detected. In this case, you will be able to avoid problems and recovery will be much faster.

Piriformis syndrome is a neurological disease characterized by unpleasant pulling sensations in the buttocks and lower extremities. Symptoms also include numbness in the legs, burning in the heel, and severe tension in the legs.

The piriformis muscle is located under the gluteus maximus. It has a triangular shape. At one end it is attached to the colonic part of the sacrum, at the other - to the trochanter of the femur. The main function is to turn the leg outward.

Etiology of the disease

The main factor in the development of pain in the gluteal region is compression of the sciatic nerve. Disruption of the normal functioning of this nerve is associated with overstrain of the piriformis muscle, which can occur for various reasons:

• hypothermia;
• incorrectly placed injection;
• pathologies of the spine and hip joints;
• damage to connective tissue in the pelvic region;
• intense physical exercise.

Other causes include weakening of the gluteal muscle due to injury or pinched nerve root of the spine. In this case, the piriformis will try to take on part of the load of the gluteus maximus. As a result, the first one will overvoltage.

Diagnostics

It is not easy to determine on your own that pain is due to compression of the sciatic nerve by piriform fibers. This is due to many reasons for the appearance of this syndrome. In such a situation, a person far from medicine may confuse inflammation with other diseases.

In addition, such pain occurs periodically, for example, after walking or sitting in one place for a long time. Therefore, an accurate diagnosis should only be made by a neurologist.

As a rule, a specialist carries out a number of manual measures to identify the presence of the syndrome in question. For example, a common technique is to palpate the affected area and identify areas of pain and lumps in the muscles.

At the same time, the doctor learns from the patient about previous diseases of the musculoskeletal system, operations, and sports injuries. Computed tomography and ultrasound are used as auxiliary methods.

Treatment

In the absence of serious pathologies, the doctor, as a rule, diagnoses physical overexertion. The main method of therapy in this case is rest for several days. It is necessary to give up sports activities and prolonged sitting in one place. Light walks and resting while lying on your stomach are recommended.

If the causes of piriformis syndrome are pathological changes, the neurologist may prescribe one of the treatment methods discussed below.

Postisometric relaxation

It is a set of exercises for piriformis muscle syndrome, which allows you to relieve spasm from the affected muscle and thereby release the pinched nerve and get rid of pain. Performed independently at home:

1. We sit on the edge of the chair. We lift the “sick” leg and place it with the ankle on the opposite knee. We lean forward. There should be a feeling of strong stretching in the lower back and affected buttock. Press your elbows to your raised shins, exhale and lower your body lower. With each subsequent exhalation we bend a little further. Perform until the gluteal muscle is stretched to maximum extent.
2. We lie down on our backs. We pull the knee of the “sick” leg towards ourselves. We clasp it with our palms and perform short pulling movements, trying to bring the thigh as close to the stomach as possible. Repeat for 30 seconds. Then, leaving the knee raised, we take hold of the shin and gently pull it up. We continue for half a minute. Having completed the exercise, very smoothly straighten the leg and stretch out on the floor. We rest for 30 seconds.
3. We lie on our backs. Knees bent, feet firmly on the floor. We lift the “sick” leg and press it with the ankle to the opposite thigh. From this position, we smoothly twist the lower part of the body towards the “healthy” leg and lower the raised foot to the floor. We turn our head in the opposite direction. We stay in this position for 1 minute.
4. We get into a deep lunge. In this case, the “sick” leg should be in front. We abduct the “hind” limb as much as possible. After this, very carefully lower the side of the hip that is exposed forward onto the floor and lie down on it with your stomach. We stay in this position for 1 minute.
5. We get on all fours, bend the “sick” leg at the knee and lift it. Then we move the raised hip to the side and straighten the limb back. After this, we repeat all movements in reverse order. We move like this for 1 minute.

During training, avoid sudden jerking movements. Exercises to treat piriformis syndrome must be performed at least 5 times a week. For starters, two laps per session is enough. The number of training cycles should be gradually increased.

Drug treatment

To relieve pain and relieve inflammation from the piriformis muscle, the following drugs are used:

• antispasmodics (Maksigan, No-shpa, Tempalgin, Papaverine, etc.);
• anti-inflammatory (Finalgon, Viprosal, Teraflex, Chondroxide, etc.);
• anesthetics (Lidocaine, Novocaine).

Manual therapy

Performed by a specialist. This also includes massage. The main goal of such activities is to relieve tension from the piriformis muscle, release the sciatic roar and restore normal blood supply to the pelvic area. In combination with drug treatment, it gives the best results in getting rid of the disease.

Physiotherapy

This type of therapy consists of many techniques to relieve pain, eliminate inflammation, and return the patient to mobility and performance. Such techniques include: shock wave exposure, electrophoresis, acupuncture, laser acupuncture.

Taping

It involves the application of special fixing tapes (tapes) to the affected area of ​​the body. The procedure allows you to relieve tense muscles, improve blood circulation, and reduce pain.

In our case, a special technique is used to treat piriformis muscle syndrome - kinesiotaping. The main advantage of such therapy is maintaining the patient's mobility.

Prevention

• Try to spend more time in movement - walk, do gymnastics, exercises.
• Keep your lumbar region warm.
• Protect the spinal column from injuries and bruises.
• Warm up your entire body well before physical activity.
• After intense training, stretch the muscles of your legs and buttocks.
• Visit a massage therapist regularly.
• If you exercise, give your body enough time to restore all tissues, eat well.

If rest and pharmaceutical ointments cannot relieve pain in the gluteal region, seek help from a neurologist. Don't delay your visit to the doctor. Otherwise, you risk aggravating the course of the disease.