This illustration shows a cut away of the Gluteus Maximus-and-Piriformis. Notice the Piriformis is right under the GM.
This is showing the Piriformis muscle and its attachment starting from the Sacrum edge to the tip of the femurs’ Greater Trochanter.
Piriformis-syndrome-This illustration is demonstrating the Sciatic Nerve placement running from the Sacrum bone, into the pelvic region and down behind the Piriformis
This is an illustration of the Piriformis and the sciatic nerve showing the 4 possible pathways the sciatic can take passing the Piriformis.
1-The Sciatic runs down and behind the Piriformis, this is the normal pathway.
2- The Sciatic splits around the Piriformis.
3-The Sciatic splits with one part going through the Piriformis causing constant pain from pressure especially when it is inflamed.
4- The entire Sciatic goes through the Piriformis and causing pain almost all the time especially when the Piriformis is inflamed or has direct pressure.
Sciatic nerve and Piriformis syndrome are synonymous with each other when it comes to pain symptoms. The pain is in the same area causing a miss diagnosis of what is really casing the pain. Is it the nerve or the muscle or both? A well trained doctor or PT can figure it out, if they take the time to listen and observe. Also, a proper diagnosis should include palpation of the area to feel if Piriformis swelling is present and that may be the cause to the aggravated Sciatic Nerve. Knowing the cause to the problem of which came first will lead to a more successful rehab or strength training program. When the diagnosis quickly blames the Sciatic Nerve, it may be a good quick guess to satisfy the patient, but might not solve the problem.
This illustration shows a cut away of the Gluteus Maximus-and-Piriformis. Notice the Piriformis is right under the GM and the Sciatic Nerve runs under the Piriformis.
When Piriformis Syndrome is advanced, it produces bad posture which can lead to other problems.
When treating the swollen Piriformis, sit on ice every day 3 times a day for 30 minutes each time. Place the ice bag on a sofa cushion so to soften the pressure. Once the area is so cold it become numb, try to stretch as shown in this section. You have to be aggressive for the spasm in the Piriformis to go away, don’t worry it won’t break. Take every day precautions to prevent the inflammation from coming back. Make sure you are not sitting on a wallet during the day. Have shoe orthotics made custom for your feet to re-align your posture. Don’t sit too long during the day and stretch as often as you can.