what causes piriformis syndrome

What I am not going to do in this post is give you a long list of things that can potentially cause PIRIFORMIS SYNDROME.  Over the course of many previous posts, I have essentially done that several times over (HERE).    What I am going to do is make this even more simple and break it down into two categories (these are assuming that your pain is not the result of a systemic disease process such as THIS). 

• There are those people dealing with Piriformis Syndrome that will, unfortunately, require surgery to attain any degree of lasting relief. 

• There are those who will be able to find relief from their problem without surgery. 

Fortunately, the vast majority of you who suffer with Piriformis Syndrome will not have to undergo surgery in order to find relief.  In fact, Piriformis Release Surgery is the last place you want to start (along with the endless MRI’s, NCV’s, CT’s, EMG’s, etc, that accompany it).  Why?  Just look around the internet, read the Piriformis Syndrome Message Boards, and check out what the Piriformis Syndrome Support Groups are saying.  Yeah; I get it —- there are people who respond favorably to Piriformis Surgery.   But there are many who do not.  And once you have had a surgery, you cannot un-have it. 

The thing to remember is that even though the Piriformis Muscle is the place where the SCIATIC NERVE actually gets pinched / irritated / compressed / impinged, stretched, it is frequently not the primary source of said irritation. Allow me to explain.  Pelvic Distortion (SUBLUXATION) is a common cause of Piriformis Syndrome, and can occur almost anywhere —- not just at the site of pain.  Many times, these patients will tell me that even though Chiropractic Adjustments are the only thing that helps them, they have to go back continually because they will not hold an adjustment more than a couple of days (or even a couple of hours).  This is because many times the cause of the Pelvic Distortion is relentless FACIAL ADHESIONS or TENDINOSIS.  They get adjusted but the Scar Tissue is constantly pulling the joint.  Again, these restrictions are often found in areas that are fairly distant from the point of pain.

HERE is an example of what I am talking about.  This is why sometimes I end up spending one hour, two hours, or even longer with these patients, trying to figure out where the primary Adhesions are. Some of these cases are like trying to solve a crazy three dimensional jigsaw puzzle.  Do I help everyone that comes to see me?  Certainly not.  However, if your particular case of Piriformis Syndrome can be helped without surgery, there is a good chance that I can figure it out for you (HERE and HERE).  I have many videos of patients who, before they came to see me, dealt with Piriformis Syndrome for decades.  You can see a few of them HERE or HERE.