Pyriformis Syndrome

Ross Hauser, MDRoss Hauser, MD

Chiropractors and physical therapists love to give people the diagnosis of pyriformis syndrome. “Your sciatic nerve is getting pinched by the pyriformis muscle.” People then spend years stretching out the pyriformis to try and “unpinch” the sciatic nerve. Since the person doesn’t have sciatica or lumbar radiculopathy, the pyriformis syndrome diagnosis is wrong. Please read information about Lumbar Radiculopathy and sciatica. It applies to the diagnosis of pyriformis syndrome as well. Back to basics! Let’s go back to common sense principle number one. If the treatment a person is doing is not resolving the condition, then something is wrong. Another good sense principle is “if nothing changes, nothing changes.” In other words, if a person continues doing the same types of stretches, the same therapies, the same medications or the same herbs, or the same exercises, then the results will be the same. So doesn’t it make sense if a person is not getting better with a current therapy geared at a certain diagnosis that perhaps the diagnosis is wrong? What do you think?

Pyriformis syndrome is very rare. Think you have it? I dare you to prove it. Go get an EMG/NCV test and see if you have it. When your EMG/NCV test comes out normal, then go to a Prolotherapy doctor to get an evaluation for lower back/sacroiliac joint Prolotherapy.

• If your EMG/NCV test is positive, what are you going to do? Get surgery on your pyriformis muscles? I wouldn’t! Why not get Prolotherapy to your lower back and sacroiliac joints?

• Perhaps your pyriformis muscle is in spasm because it is trying to contract against an unstable base? What is the unstable base you ask? It is the innominate bone? Why is it unstable? Great question. It is not stable because the sacroiliac joint on that side is loose. Just stabilize it with Prolotherapy then the pyriformis muscle can contract against a stable base. Once that happens, the muscle spasms stop and so does the sciatica. Either way, Prolotherapy is your best bet!