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Piriformis Syndrome During Pregnancy

During pregnancy, a fairly rare condition labelled “piriformis syndrome” is more likely to occur. This article will explain what that is and what to do about it.

What happens with piriformis syndrome is that the pregnant woman begins to secrete the hormone “relaxin” which increases pelvic stretch and can potentially open up the space in the sacro-iliac joints. 

Her spine also increases in lordosis (the curvature going anterior), which tilts the pelvis forward, moving it into increased flexion.  These things combined cause the gluteal muscle group of the hip/pelvis to become elongated and strained, especially the deep, small muscles of the hip… including piriformis.

Piriformis syndrome refers to a deep gluteal/low back pain that is accompanied by parasthesia down the posterior of the lower limb, reaching into the back of the thigh and possibly into the back of the calf and sole of the foot. 

A true piriformis syndrome would also be accompanied by numbness or tingling of the lower limb, as the aggravated piriformis muscle begins to compress the sciatic nerve.  These neurological symptoms down the leg are often referred to as “sciatica”.

Registered Massage Therapy by an RMT can be a very effective way of treating pain caused by piriformis syndrome.  Due to the area that piriformis is located, be aware that the RMT will want to drape high around the gluteal region, and may want to access the hip adductors on the inner thigh to treat for compensation.  Always know that the treatment will be based on what the client is comfortable with. Clear communication is key in order to achieve good boundaries.

During pregnancy massage, the client is usually treated on their sides, especially during the third trimester.  Pillows will be used to support the body so that it rests comfortably on the table, leaving the client feeling secured.  Deep moist heat may be used on the gluteal region, along with massage techniques that will aim to lengthen muscles without compressing the sciatic nerve further. 

Certain stretches may be used as good ways to lengthen without compression.  The low back region should be worked on as well to help lessen the tension in the hyperlordosis of the lumbar spine.  Trigger points (hyper-irritable areas in taut bands of muscle fibre that cause muscles to shorten and refer pain to other regions of the body) may be found during treatment. These should be treated using compressions and stretching to alleviate other causes of contributing pain.

Although the occurrence of piriformis syndrome isn’t readily eliminated due to the physiological and postural/biomechanical aggravating factors during pregnancy, massage therapy can be used as a preventative measure and to relieve symptoms when aggravated. 

Post-partum, new mothers that avoided piriformis syndrome during pregnancy may encounter it afterwards due to positions assumed during labour, long periods of sitting on the buttocks, and prolonged inactivity. 

Although the post-partum period requires much inactivity from new mothers caring for their newborns, this is the most important time to actively recondition your muscles and joints through light activity, regular stretching and massage therapy.

After a massage therapy session, an RMT will give self-care information to the client.  Following self-care guidelines post-massage is vital for maintaining the changes made to the body by the treatment for as long as possible, as well as maintaining general good tissue health to avoid any painful conditions from resurfacing. 

Most RMTs will suggest a series of treatments closer together over a couple of weeks to treat a painful condition, and then spanning them out further to a 4-6 week maintenance routine to keep your tissues in good health.

If you’re looking for relief of piriformis syndrome, contact us at 416-792-4400 or by using the form below and she will book you for a FREE 15-minute phone or in-person consultation with one of our practitioners.