Is Piriformis Syndrome Surgery Right For You?

Piriformis syndrome can affect anyone from an avid jogger to a car-bound taxi driver. The nerves of the lower back and buttocks experience lots of movement and pressure throughout the day. Because they support so much function, they can be prone to serious injury. If the injury is constant or severe, you may have symptoms that grow to impair your daily movement and comfort.

What is piriformis syndrome?

Piriformis syndrome is pressure or tightening of the piriformis muscle.¹ The sciatica nerve is close by and gets involved in the irritation. Spasms occur and compress the nerves, and can cause numbness, tingling, and pain. The numbness and pain can then spread to the legs, feet, and back.

Many people with the syndrome complain of:²

Trouble getting out of bed
Difficulty sitting for a long period of time
Chronic back and buttock pain
Back pain that’s exacerbated by hip motions

The piriformis muscle is under several layers of muscles of the buttocks. It helps you move your thigh from side to side. Because it’s involved in many postures and movements, the syndrome can be very frustrating and discouraging to live with. When it’s serious, many people struggle to find relief with exercise or with rest.

Piriformis syndrome can be caused by overuse, underuse, or over-extension. For example, an individual could develop piriformis syndrome from frequent vigorous running, constantly sitting at an office job, or suffering a car accident. Once in a while, a person develops the syndrome due to abnormal anatomy. For a more detailed explanation, visit our other blog post discussing the syndrome.

How to treat piriformis syndrome

If you need piriformis treatment, conservative methods are generally tried first.³

Physical therapy may be able to help you stretch out the muscle. You may also learn about appropriate body movements and how to sleep with piriformis syndrome.
Anti-inflammatory medication and muscle relaxers may also help. Inflammation and tightness compress the nerve, producing the pain.
If it’s related to an environmental problem, like a sedentary lifestyle, habits and the environment can be readjusted.
Injections into muscle may also help temporarily numb or paralyze the muscle, keeping it from tightening or hurting.

However, for some people, these methods only provide temporary relief or don’t help at all. Some environmental factors may not be easily rearranged. For example, piriformis syndrome related to buttock pressure from waist-down paralysis may be more challenging to treat.

If conservative methods don’t work, surgery can be an excellent source of relief.⁴ Sometimes the surgery is called decompression, as it decompresses the nerves.

Because so much movement and resting relies on the muscles and nerves of the buttocks, the problems that can affect them can be profound. Sitting, standing, laying down—if there’s pain in the piriformis and sciatica, it hardly leaves you alone. Allowing piriformis syndrome to progress can increase damage and decrease your quality of life.

What is piriformis syndrome surgery?

Piriformis syndrome surgery relieves the irritation or pressure on the piriformis nerve. Cuts are made in the buttock to access the deep muscle. This can be done in several ways.

By going in through a small incision through the buttocks, and cutting some of the muscle.⁵ This decompresses the tension around the nerve. The pressure on the nerve is what caused the numbness and the pain.
By removing the piriformis entirely. If the little muscle is removed, many issues can resolve entirely. Pain and pressure on the nerves from scarring and inflammation are less of a risk when the muscle is not there.⁶

But can your body function when it’s missing that muscle? It usually does just fine. It is surrounded by other muscles that take over in supporting your daily movements.

As Angela Hartlin (2018) described her piriformis removal,⁷ “I felt better after surgery than before I did going in.” (para. 10)

What can I expect from a piriformis surgery?

Before the procedure, our staff will inform you of the details of your pre-op preparation. Make sure you don’t eat after midnight before surgery, and that you have someone to drive you home.

You can expect to go home from surgery that day: it’s an outpatient procedure. You’ll be equipped with pain management tools and medications. Pain duration depends on the person.

How long does it take to recover from piriformis surgery?

Recovery time varies from person to person. However, you should be able to get back to your normal movements in four to six weeks. You’ll want to stick to Dr. Tollestrup’s recovery plan for optimal healing!

What kind of doctor does piriformis syndrome surgery?

Piriformis surgery is typically performed by an orthopedic, nerve, plastic, or reconstructive surgeon.⁸ Because this surgery deals with the sciatic nerve, it’s important that your piriformis doctor be very familiar with the syndrome. It’s an important peripheral nerve, as well as the body’s largest and longest nerve.

Dr. Tollestrup specializes in peripheral nerves, and their related pain and problems. If you’re having sciatic nerve pain, you’ve come to the right place. Your care will be supported by his thorough experience and knowledge. He has several diagnostic tools to help assess your troubles and determine whether surgery is right for you. This may involve:

Exploring your history. Discuss your symptoms, physical challenges, and patterns of pain. What have you tried in the past that hasn’t worked?
A physical examination. By assessing your movements and pain points, Dr. Tollestrup will get a better understanding of what muscles and nerves may be affected.
Imaging. An MRI, X-ray, or bone scan can be used to explore the troubled area. To prescribe the best treatment, it’s important to rule out other health problems that might be going on.

Don’t struggle through piriformis syndrome pain any longer.

Dr. Tollestrup and his team are ready to help you get back to moving and resting without pain. If you’ve been looking for a peripheral nerve specialist in Las Vegas, it’s time to make an appointment with us today. Call us at 702-505-8781, or fill out our New Patient Form.

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