Piriformis syndrome occurs when the piriformis irritates the sciatic nerve , which comes into the gluteal region beneath the muscle, causing pain in the buttocks and referred pain along the sciatic nerve.  This referred pain is known as sciatica . Seventeen percent of the population has their sciatic nerve coursing through the piriformis muscle. This subgroup of the population is predisposed to developing sciatica. Sciatica can be described by pain, tingling, or numbness deep in the buttocks and along the sciatic nerve. Sitting down, stretching, climbing stairs, and performing squats usually increases pain. Diagnosing the syndrome is usually based on symptoms and on the physical exam. More testing, including MRIs, X-rays, and nerve conduction tests can be administered to exclude other possible diseases.  If diagnosed with piriformis syndrome, the first treatment involves progressive stretching exercises, massage therapy (including neuromuscular therapy) and physical treatment. Corticosteroids can be injected into the piriformis muscle if pain continues. Findings suggest the possibility that Botulinum toxin type B may be of potential benefit in the treatment of pain attributed to piriformis syndrome.  A more invasive, but sometimes necessary treatment involves surgical exploration; however, the side effects of the surgery could be much worse than alternative treatments such as physical therapy. Surgery should always be a last resort.  A promising non-invasive treatment for piriformis syndrome is the application of KT tape at trigger points.
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