The piriformis muscle, located deep in the buttock, can cause a great deal of pain if it goes into spasm. The chiropractic approach to diagnosing this syndrome includes a full evaluation of your spine and pelvis and the related musculature. A functional, orthopedic and neurological examination is normally also performed.

Dysfunction in the sacroiliac joints is one contributory factor, which can lead to neuromuscular dysfunction causing weakness in the other muscles in the area. Several activities are said to aggravate the pain of piriformis syndrome such as walking, sitting, climbing stairs, performing squats and running, but they are so general as to be unreliable for diagnostic purposes. The chiropractor will look for several signs of piriformis syndrome:

• A possible sign of a tight piriformis muscle is having one foot pointing outwards more than the other when you lie relaxed on your back.
• Direct palpation (touch) of the muscle reveals a taut and tender muscle, often with trigger points present, causing referred pain locally or down the leg.
• Either resisted external rotation or passive internal rotation of the hip may increase the pain.

Resisted muscle testing can be used to see if tendinitis is present. But since the piriformis works in conjunction with several other muscles in the buttock area such as the quadratus femoris, obturator internus, and the superior and inferior gemellus muscles, it is difficult to be specific.

If there are neurological signs and symptoms present, several tests are performed to rule out a disc injury. Some of these tests are modified to find out if the sciatic nerve is being affected and irritated by the taut piriformis muscle, and your chiropractor is an expert in assessing the condition.

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