Sitting Still Will Cause Neuralgia too! Be Careful of Piriformis Syndrome!
Mrs. Li, about 50 years old, came to the orthopedic clinic and chiefly complained that she had suffered from pain in her left hip and left back thigh for two days, with the numbness and pain extending to the calf, and there was even cramp. A preliminary examination showed that the patient didn’t have any waist discomfort, but there was an obvious tender point in the left hip, with the pain extending from the left back hip downwards. Even hip adduction, inward turning and other movements of hip joints could cause pain, so Mrs. Li was highly suspected of suffering from piriformis syndrome instead of the common sciatica caused by herniated intervertebral disc. Chen Zhong-pei, attending doctor of the Orthopedic Department in Heping Fuyou Branch of Taipei City Hospital, says that the piriformis muscle is the deep structure of the hip, which is a banded, flat muscle and functions to stabilize the hip joints. Therefore, the balanced center of gravity during walking and most of lower limb movements will involve the piriformis muscle. Dr. Chen Zhong-pei says that piriformis syndrome sounds like a kind of muscular problem, but the compression caused by keeping a fixed posture for a long time is one of the main reasons, besides repeated and excessive exercise and traumatic impact. In particular, poor sitting posture, crossing legs while sitting, and tables and chairs with inappropriate height can all easily lead to piriformis syndrome. Besides oral administration of anti-inflammatory painkillers and muscle relaxant, hot compress, electrotherapy, piriformis stretching exercise and other physical therapies are available; patients with poor therapeutic response can also try steroid injection at the affected part. Only a very small number of patients need surgery to relax piriformis muscle. People shall avoid sitting on too hard or too short chairs for an extended period of time, or crossing legs and other poor sitting postures, and shall stand up to stretch the hip and thigh muscles after sitting for a period of time. It will help to avoid the formation and recurrence of piriformis syndrome. As most sciatica and hip pains are not caused by piriformis syndrome, careful examination and differential diagnosis is quite important. Dr. Chen Zhong-pei reminds the public that should you experience similar symptoms, please seek medical advice and ask specialist physicians for evaluation as soon as possible, in order to get the most appropriate treatment.
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