Contracture or spasm of the piriformis muscle in the hip. It usually affects only one side, but can be bilateral.
It is caused by injury to the piriformis muscle, which can occur from overuse, such as prolonged sitting, overexertion, running, walking or other repetitive activities, playing sports, climbing stairs, lifting heavy objects, traffic accidents, falls, sudden twisting of the hip and/or penetrating injuries.
The main symptom is sciatica (pain in the area of the sciatic nerve). Other symptoms include tenderness or brief pain in the buttocks, numbness or tingling in the buttocks along the back of the leg, difficulty sitting, pain when sitting that gets worse with continued sitting, pain that gets worse with activity, and pain in the lower part of the body that is so severe that it incapacitates you.
Diagnosis is made by taking a medical history, performing a physical examination and using imaging tests such as an MRI or CT-scan to rule out other causes.
Treatment is based on controlling the symptoms through postural control, anti-inflammatories, muscle relaxants, electrotherapy and, in the last resort, surgery.
- Rob Johnson, MD. Approach to hip and groin pain in the athlete and active adult. Uptodate. Jul 06, 2017.
- Lisa R Callahan, MD. Overview of running injuries of the lower extremity. Uptodate. Jun 13, 2017.
- Roger Chou, MD. Subacute and chronic low back pain: Nonsurgical interventional treatment. Uptodate. Jun 21, 2017.
- Rankin AT, Bleakley CM, Cullen M. Hip Joint Pathology as a Leading Cause of Groin Pain in the Sporting Population: A 6-Year Review of 894 Cases. Am J Sports Med 2015; 43:1698.
- Agten CA, Sutter R, Buck FM, Pfirrmann CW. Hip Imaging in Athletes: Sports Imaging Series. Radiology 2016; 280:351.
