"Oh No!" It's the acute or chronic feeling of pain, hot or cold, numbness, weakness, "electric shocks," or strange sensations, starting near your buttocks and going down your leg. You've got sciatica, and all you know is that it can be excruciating. Sciatica may originate in your brain, your back, or where you sit, stemming from nerve problems in the back or entrapped nerves in the pelvis or buttocks. What causes the pain is just as varied and potentially confusing. The trouble is often due to a herniated disk, spinal stenosis, or piriformis syndrome--a commonly misdiagnosed compression of the sciatic nerve by the piriformis muscle. Here we are going to tell you how to self-diagnose whether you have piriformis syndrome.
If you are wondering if you have piriformis syndrome you can do a lot to diagnose yourself at home. First, is the pain worse when you are sitting down? Do you have pain, numbness, and/or weakness in the buttocks, down the back of the leg, or both? Without such pain and discomfort, you can rule out piriformis syndrome. Next, if you press on the muscle in each buttock, just above the middle of the cheek, and you have pain on one side or both sides, that is another indication that you have piriformis syndrome. Sometimes you can feel the muscle in spasm there. If you don't feel any pain, tenderness, or discomfort with this pressure, chances are you don't have the problem, though there are a few exceptions to this rule. Third is the classic "straight leg raise test". To do this, you will need someone to help you out. First, you lie flat on your back on a hard surface. Next, the person helping you, will raise your legs one at a time. As this is being done, you must let this person know at what point you feel pain and at what angle you feel it. If the angle is between 30 and 60 degrees and the pain is in the back, it often indicates irritation of nerve roots that form the sciatic nerve. Bending the knee while the leg is still raised should relieve the pain. If this does not relieve the pain then the problem is probably in the hip. If the pain is in the back of your knee and occurs at the same angle for both legs, you may have nothing more serious than tight hamstrings. If, however piriformis syndrome is present, this test should cause more pain on the side that is most affected.
Next we will explain how to perform the FAIR test at home. A simple form of this test, without an EMG machine was created by a Norwegian surgeon named Solheim and is commonly referred to as the Solheim Test. First, lie on your side on the floor, with the painful side up. Next, bring the knee of the leg on that side down to the floor, without turning over and without facing downward. A friend can do that part and the next. Now press ypur knee downward and move the ankle upward, more or less using the leg as a crank to turn the hip joint counterclockwise(to the left)and clockwise(to the right). If you feel pain you may well have Piriformis Syndrome.
There is also a test called the Paces Test, which also requires the help of a friend. Assume the same position as at the start of the Solheim Test. Raise your bent leg. Your friend should now try earnestly but not too vigorously to keep it down Once your leg is up in the air, hold it there. If you are weaker on one side than the other, that is another indication that you may be suffering from Piriformis Syndrome. If you experience any severe abnormalities while performing these tests, you may want to go see your doctor for the full version of the Fair Test with an EMG machine.
A conventional X-ray will not show piriformis syndrome, nor will any standard MRI or EMG. However, the spasm of the piriformis muscle can affect the sciatic nerve and can damage or even sever some of its fibers, and an EMG can pick up that damage.
The various types of exertion that could have caused piriformis syndrome in the first place can also make it worse, or make it begin again if it has eased up. Running on a treadmill is an example of this, as is walking up steep stairs or a hill, or heavy lifting for a long period of time.
Most of the time, people who have piriformis syndrome have it on one side, then get it on the other side as well. The pressure of the abnormally large or stiff piriformis muscle pulls the sciatic nerve taut. The recommended physical therapy for Piriformis Syndrome is two or three times per week for one to three months. We sincerely hope that this has made it easier to tell whether you have this sydrome before you spend a lot of money and time on worthless doctor visits that may not tell you any more than these simple tests will tell you. And we hope that this will help you to tell the difference between sciatica pain and the discomfort and Piriformis Syndrome.
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