Piriformis Syndrome and Walking

Man running up hill
Walking uphill can worsen piriformis syndrome symptoms. (Image: Jupiterimages/Pixland/Getty Images)

A pain in the buttocks can be more than a pain -- it can be a debilitating symptom that makes walking, sitting or normal exercise difficult. Compression of the sciatic nerve often causes pain that runs through the buttocks and down to the foot. The piriformis muscle, which connects the femur, the large bone in your leg, to the base of the spine, can compress the sciatic nerve, causing pain and disability. Simple stretching exercises, massage and rest can help treat piriformis syndrome severe enough to interfere with daily activities such as walking.

Causes

The piriformis muscle runs very close to the sciatic nerve. In between 15 and 20 percent of cases, the sciatic nerve actually runs through the piriformis muscle, according to the Irwin Army Community Hospital. Sciatica occurs when the nerve becomes compressed. This often occurs because of abnormalities within the spinal cord, but any compression can cause sciatica pain. Strain in the piriformis muscle and swelling from overuse, muscle spasms or tightness in the muscle from sitting for long periods of time can all lead to sciatic nerve compression. Compensation for other mechanical foot or leg problems such as pronation or having one leg shorter than the other can also cause piriformis syndrome.

Symptoms

Symptoms of piriformis syndrome can vary, depending on the severity of the compression of the sciatic nerve. You might feel minor aching in your buttock or down your thigh, heaviness or weakness in the leg or pain like an electric shock when you move. Your foot could feel numb or tingling, with a pins-and-needles feeling, making walking extremely difficult. One part of your leg could feel numb and another part painful. Sitting for long periods can worsen the pain, but walking for long periods of time or walking up hill or running can also make it worse.

Treatment

The first treatment for piriformis syndrome is to rest the muscle so that spasms decrease or swelling goes down. This takes the compression off the sciatic nerve. Decrease your running or strenuous walking activities for two to three weeks, podiatrist and sports medicine specialist Stephen Pribut recommends. Stretching exercises can also help relax the muscle and keep it from tightening up on the sciatic nerve. To stretch, pull your knee up and toward the opposite shoulder. Grasp your knee with your hand and pull gently back, holding for 30 seconds. Repeat three times twice a day. You can also pull both your knee and foot upward at the same time until you feel a stretch in the hip. Hold for 30 seconds and repeat three times twice a day. Massage might help, but the muscle is hard to reach, Pruit states.

Prognosis

Many cases of piriformis syndrome will heal spontaneously within two to six weeks. To prevent a recurrence, always stretch and warm up before starting any strenuous activity such as a long walk or run. If you notice symptoms returning, decrease your activity level and continue stretching exercises. If symptoms interfere with walking by causing numbness or weakness in your leg or foot, see your doctor. In rare cases, surgery might become necessary.

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