Q: I have recently been experiencing pain in my right buttocks and it travels down my leg into my calf. I went to my doctor, and she diagnosed me with having Piriformis syndrome. Is this something with which Massage Therapy can help? And what should I expect on my first visit?
A: Yes, Massage Therapy can definitely help! Piriformis syndrome develops when your sciatic nerve gets compressed/irritated by your piriformis muscle (which is a small muscle located in your buttocks). This compression or irritation ends up causing pain, tingling and numbness into the buttocks and back of the leg.
It can be caused by many different things including: an injury or fall, arthritis, post surgery swelling, overuse injury (i.e. driving for a long period with your foot on the accelerator), postural issues or anything that leads to trigger points (knots), causing shortening in the piriformis (like having a wallet in your back pocket and sitting on it).
Massage therapy can help relieve some of the discomfort and pain associated with piriformis syndrome by decreasing the compression of the piriformis muscle on the sciatic nerve. At ProActive Rehab, your massage therapist will start your session with an assessment, which may include taking your health history, asking a series of questions regarding your situation, testing your range of motion and other orthopaedic testing, to gain as much knowledge of your condition as possible.
The goals of your treatment will be to help relax the piriformis muscle as well as the tissue and muscles surrounding it. Your massage therapist may want to treat not only your leg and hip on the affected side but also the compensating structures like the unaffected side and your lower back as well.
Your treatment may include moist heat to start, followed by massage therapy techniques, trigger point therapy and passive range of motion of the hip and leg. Your RMT may also use some joint mobilization and tissue stretching as well. Commonly, you will be given some stretches, exercises, self-massage/releasing techniques and ice/heat application to be used at home. At ProActive Rehab your RMT will create a treatment plan with you, outlining important, measurable goals and recommended treatment, what to expect with the massage, and the frequency and duration of your treatment sessions.
Keep in mind that piriformis syndrome treatment can be painful or cause some discomfort to the client, so be sure to let your massage therapist know if you need the treatment to be modified in any way (including increasing/decreasing pressure, avoiding certain techniques/areas of the body or stopping treatment completely). It is important for both the client and the therapist to be comfortable with the treatment plan and techniques used. Be aware that a side effect to this treatment may be tenderness in the area treated and possibly some light bruising.
To help with post massage soreness, heat to the area treated can be beneficial. Don’t hesitate to ask your RMT any questions regarding your treatment or injury at any point! Please call us at ProActive Rehab (705) 788-1480 to book your appointment today!
Leslie Tempest, BScPT is a registered physiotherapist with the College of Physiotherapists of Ontario. She graduated from the University of Western Ontario with a Bachelor of Science in Physiotherapy in 1992. She has practiced in a variety of fields and locations including a 3 year stint in England. Her experience is varied but has primarily focused in an out-patient environment and in private practice since 1996. Over the years she has taken many post-graduate training courses and has developed an interest in biomechanics, manual therapy and preventative education. She also enjoys working with dancers and athletes to overcome injury and develop improved training programs for strength development and injury prevention. She is also fully trained in the McKenzie method of mechanical diagnosis and therapy. She became the owner/operator of her own clinic in 1999 and it now operates as ProActive Rehab & Sport Injury Centre!