During the daily treatment, a large number of middle-aged and elderly friends talk about their pain and numbness on the buttocks, thighs, and the back and lateral sides of the calf. They always say that sciatic nerves are painful in the walking area . Do you have such symptoms?
For this reason, I seek treatment everywhere, but the results are not very ideal. The reason may be that is related to the doctor's inadequate analysis of your condition.
For this type of problem, I often hear patients telling me that a doctor from a certain hospital diagnosed with piriformis syndrome . Is this true? Let’s talk about how to view similar issues?
What is Piriformis syndrome?
There is a piriform muscle structure on the back and forth of our hips. It grows from sacral to the thighs. It mainly causes our thighs to rotate, and what comes out from the front and bottom of it is sciatic nerve , as shown in the figure below:
If the sciatic nerve is stuck at the out of the piriform muscle, it will cause pain, numbness and other symptoms in the walking area of the sciatic nerve; usually this is what everyone understands "piriform muscle syndrome" .
Maybe everyone will wonder, why does the piriformis muscle jammed the sciatic nerve? The data currently found in shows that it is mainly due to indirect external force damage of the piriform muscle, such as squatting, spraining, spraining and other traction injuries, resulting in local congestion, edema, and adhesion of piriform muscle , which is the sciatic nerve.
Generally, the diagnosis of piriformis syndrome is based on pain symptoms + auxiliary body examination + image data !
mainly manifests as pain and soreness in the back of the buttocks (projection area of the piriformis muscle), which can radiate to the thighs and the back and outer sides of the calves; in severe cases, there is "burning, knife-cut" pain on the buttocks; most people are limping when walking because of pain in the lower limbs, and they have to squat down and rest for a while before they can continue moving forward.
①Barehand palpation:
Generally, the piriform muscle walking area behind the hip can touch local tension , and even the cord-like muscle bulge under your hands. Here, tenderness is more obvious.
②Special test
Maybe everyone like to use the piriform muscle tension test the most to check it. Let the patient lie on the examination bed, bend the affected limb knees, and perform internal rotation. If there is hip pain, the calf cannot be put down, or there is radioactive pain , then quickly spread the affected limb outward, and the pain will be relieved immediately, which is the piriform muscle tension test.
Generally, MRI or ultrasound examination will be taken to determine whether there is edema in the piriform muscle. If so, it may also be combined with lower limb electromyography to check whether the conduction speed of nerve-induced potential is slowed down?
After the above examination, he was diagnosed with piriformis syndrome, so he started various conventional treatment methods :
In pain departments or orthopedics, doctors like to prescribe painkiller to patients ( nonsteroidal anti-inflammatory drugs, muscle relaxants and nervous system drugs such as pregabalin ), or to treat injection of piriformis muscle in the buttocks.
, but the rehabilitation department relaxes the piriformis muscle and designs some methods to exercise. , such as the following methods, may alleviate or relieve symptoms, , but it will rebound, making you struggle to doubt your life!
Is the diagnosis of piriformis syndrome too flirting?
The purpose of my writing of this popular science article is not to tell you how to diagnose piriformis syndrome? I would like to explain why the pain and numbness of these patients diagnosed with piriformis syndrome did not improve after various treatments, or even if it improved, it was short-term, and the pain was repeated again and again?
You can imagine if this type of problem was diagnosed as piriformis syndrome is too superficial ? Why is there no clear trauma? In normal life and work, the piriformis muscle will become congested, edema, adhesions, and nervous?
In order to better serve patients, strongly suggests that can further consider the underlying logic of behind the tension of piriform muscles; first starts with the anatomical position of piriform muscles:
piriform muscles are grown between the sacrum and the thigh bone of the pelvis. The muscles near it grow in the same direction as it is, which makes our thighs rotate. If their length changes, they will be tight and shortened. There is only one possibility that the structure of the pelvis changes, such as the left and right asymmetry of the pelvis, or the up and down shift or the front and back shift .
Why do these structures change? and most people with symptoms of pain and numbness have no clear trauma. is not difficult to understand, and it is closely related to our living habits , such as the following situations:
Long-lasting sitting posture
Long-term standing posture
Cross the legs
cross the legs
5
Sitting mahjong
Fatty-Pelvic tilt
Are the above pictures very common in our daily lives? They are the culprits of the pelvis dislocation and disorder changes. If you do not analyze and deal with these abnormal structures and relax with the muscles growing on the pelvis, aren’t you doing something about covering your ears and stealing the bell?
Therefore, when discovering this type of problem, we must analyze and consider overall. After all, the nerves growing on the pelvis, in addition to the sciatic nerve, there are also many nerves that innervate the buttocks, which will also be affected.
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