Lower back pain, falling down the back side of the leg, is most commonly associated with disorders of the interfering discus. But, there are other causes of irritation of the ischemic nerve (disorder of the faceted joints of the spine, tendonitis of the hamstrings of the upper leg, the adhesions in the sitting area) One of the important causes is the pressure on the nerve caused by the pyriform muscle – Piriformis syndrome occurs in athletes who often perform the abduction movement of the hip joint with an external rotation. The reason for the occurrence of damage to the nervous system is its position-close relationship with the pyriform muscle. Having that said, the standard anatomical position of the nerve is that it passes directly behind the piriform muscle. However, in every sixth person, the nerve passes through the muscle itself, leading to a predisposition to the ischemia in muscle activity of the piriformis.
A suspicion of this condition is raised when stretching of the piriformis significantly increases pain along the back of the leg. Stretching is achieved by simultaneous passive flexion, adduction and internal rotation of the hip joint. The position may be in the lying position or standing with the examined leg on the chair. Demonstration of the diagnosis of piriformis syndrome is performed using several diagnostic methods: radiography, magnetic resonance and electromyoneurography.
In the treatment purpose, stretching exercises are used up to the limit of pain for 30 to 60 seconds, several times a day, preferably with the addition of therapeutic ultrasound. For resistant cases, steroid injection, prolonged therapy or surgical treatment is used.