Often mistaken for sciatica, piriformis syndrome is a condition that affects the piriformis muscle that starts in the lower spine and continues to the buttocks. If this muscle becomes irritated or inflamed, the nearby sciatic nerve may also be affected. However, treatments for sciatica may not be successful if the piriformis muscle is part of the problem. If you’ve tried other treatments for piriformis syndrome without success, Santa Monica spine surgeons want to share a few lesser-known remedies that may provide relief.
The purpose of electrotherapy is to use mild electrical impulses to stimulate muscles and nerves. The electrical stimulation is applied to the buttock area to ease muscle spasms or disrupt the transmission of nerve signals to the part of the brain that interprets pain. There are two common forms of electrotherapy:
- Transcutaneous Electrical Nerve Stimulation (TENS) Units
Electrodes are placed on the skin, and the TENS units are delivered by the patient with a small, battery operated device with this form of electrotherapy. The electrical impulses also increase the production of endorphins, the body’s natural pain relievers. Initial settings are programmed by the doctor. Eventually, the patient will be able to make adjustments to the device based on pain levels.
- Interferential Current (IFC) Stimulators
High-frequency electrical impulses are delivered through electrodes placed on the skin. IFC penetrates deeper into the skin than TENS units and may be more comfortable for some people. The treatment may also increase range of motion since it provides more direct stimulation to the piriformis muscle.
If pain from piriformis syndrome isn’t being minimized or controlled through other methods, injections may be administered directly to the affected area. The injections may be in the form of what’s termed a “piriformis injection” because it is directly placed in the muscle. Similar to an epidural injection, the shot is delivered with a local anesthetic and corticosteroid to ease the inflammation of the muscle.
When piriformis injections aren’t providing sufficient relief, a Botox (onabotulinumtoxinA) injection may be recommended. The injection weakens or paralyzes the piriformis muscle. As a result, it’s less likely to be affected by inflammation. Weakening the piriformis muscle may also ease pressure on the nearby sciatic nerve.
Piriformis and Botox injections may also make it easier to participate in physical therapy without distracting pain. Certain exercises can increase the flexibility of the piriformis muscle and strengthen muscles in the same area, including the iliopsoas muscle that helps stabilize the lower back.
Initial treatments for piriformis syndrome may involve passive or active physical therapy or the use of ice and heat therapy. Some patients find this remedy more effective when alternating applications of warmth and cold to the affected area. Anti-inflammatory medications like ibuprofen and naproxen may also ease tissue swelling and allow the piriformis muscle to heal.
Piriformis syndrome is just one of many conditions that causes pain in the spine area. Much like there are different spinal conditions, there are also various options for treatment (depending on the condition), including spinal cord stimulation and extreme lateral interbody fusion. Santa Monica patients with piriformis syndrome or another form of chronic back or neck pain can rely on the trusted surgeons at The Spine Institute Center. Call 310-828-7757 today to schedule an appointment.