A low back pain condition describes as a compression or irritation of the sciatic nerve by a contracted or stretched piriformis muscle which causes aching in the posterior thigh and occasionally extends to the foot. It may be associated with tingling and weakness In a percentage of the population the sciatic nerve passes through the piriformis muscle.

Diagnosis

Diagnosis of piriformis syndrome is derived from a thorough patient history, neurological exam, orthopaedic tests, chiropractic assessment with no indicators of potentially serious pathology. Imaging is only indicated in patients with a positive neurological exam or presence of a “red flag” [64-67].

Evidence Base

No specific randomised controlled trials assessing the effectiveness of chiropractic manipulative therapy for this problem is known by this author.

However to date, the Committee of Advertising Practise (CAP) accepts that the holistic approach that chiropractors take, they may claim to treat general aches and pains resulting from muscle spasms and cramp.

Back-in-Action clinic comment

The main aim of treatment is to reduce the muscle spasm and its causes. Initially stretching and muscle release techniques are applied. Self help advice would include home exercises and use of ice or heat as appropriate. Massage treatment or acupuncture may also be recommended. Spinal manipulation and mobilisation may be applied to improve the movement of joints in the leg and spine. We often find correction of underlying postural problems is effective for long term relief. These may include use of foot orthotics, use of functional neurological approaches, improving sitting position (ergonomics) and cranial approaches. Nutritional recommendations may be made in some cases.