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Piriformis Syndrome – Treatment

shutterstock 141220330 200x300 - Piriformis Syndrome - TreatmentThe piriformis muscle is located deep in the hip and extends in close proximity to the sciatic nerve. Upon becoming tight and/or swollen, it can lead to irritation of the sciatic nerve. This irritation causes sciatica-like pain, numbness, and tingling.

Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides orthopedic surgery to patients in Los Angeles, Century City, CA, and surrounding communities.


Treatment Options

Various treatment options may be recommended by a medical care professional, depending on the severity of the sciatica-type pain that the patient is experiencing and other symptoms.

A thorough approach to piriformis syndrome management may include a combination of the below mentioned non-surgical treatments:

  • Ice Packs and Ice Massage.
  • Ice and Heat Therapy for Piriformis Syndrome.
  • When the pain initiates, the patient may lie in a comfortable position on the stomach and apply an ice pack on the painful site for around 20 minutes. Repeat as necessary every two to four hours.

Combining a gentle massage with the ice may be more helpful. The patient should lie on their stomach and ask someone to massage the painful site with a large ice cube gently.

If the ice is placed on the skin directly (rather than using a cold pack), the application should be restricted to 8 to 10 minutes to prevent ice burn. If the pain increases after specific activities, it may be advisable to apply ice right after the activity.


Heat Therapy

Alternating cold with heat is also beneficial for some patients. If the patient uses a heat pad, they should lie on their stomach and apply the heating pad on the painful region for up to 20 minutes. Patients should be cautious to avoid sleeping on the heating pad as this can cause skin burns.


Medications for Sciatica Pain

As a majority of episodes of pain occur due to some type of swelling, non-steroidal anti-inflammatory medications (NSAIDs), such as naproxen or ibuprofen, may help reduce inflammation in the impacted area.


Piriformis Injections

An injection may be part of the treatment for severe sciatica pain due to piriformis syndrome.

The doctor may inject a local anesthetic and corticosteroid directly into the piriformis muscle to help reduce the pain and spasm. The reason for administering an injection is often to reduce acute pain and allow progress in physical therapy.


Botox Injection

In case of a persistent piriformis spasm that is unresponsive to treatment with anesthetic/corticosteroid injections, an injection of botulinum toxin (for example, Botox), a muscle paralyzing agent, may be helpful. The objective of the injection is to enable the muscle to relax and help decrease pressure on the sciatic nerve.


Electrotherapy for Piriformis Syndrome

Electrical stimulation application to the buttock with a transcutaneous electrical nerve stimulation (TENS) unit or interferential current stimulator (IFC) can assist in blocking pain and reducing piriformis syndrome-related muscle spasms.

The piriformis muscle can be cut to alleviate symptoms in persistent cases. However, this is undertaken only in rare cases.


Piriformis Muscle Stretches

It is almost always necessary to stretch the piriformis muscle to relieve the pain along the sciatic nerve, and it can be performed in various positions.  

Many stretching exercises for the piriformis muscle, hamstring muscles, and hip extensor muscles may be done to help reduce the painful symptoms along the sciatic nerve and restore the patient’s range of movement.

Board certified orthopedic surgeon Dr. Tigran Garabekyan receives patients from Los Angeles, Century City, CA, and nearby areas for orthopedic surgery.

Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.595.1030

Serving patients in Los Angeles, Beverly Hills, Santa Monica, Century City, West Hollywood, North Hollywood Encino, Sherman Oaks, Van Nuys, Burbank, Glendale and other neighboring cities in the greater Los Angeles, California area.

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Century City

2080 Century Park East Suite 1204
Los Angeles, CA 90067
Tel: 310.595.1030 Fax: 310.582.5619