Pyramidal Syndrome or False Sciatica

What is pyramidal syndrome?

Pyramidal syndrome, also known as false sciatica, is a neuromuscular condition caused by excessive tension or overload of the pyramidal muscle. This muscle overload causes compression of the sciatic nerve as it passes through the buttock.

The pyramidal muscleis located in the deep part of the gluteal region, extending from the sacrum to the femur. Near it is the sciatic nerve, which originates in the lower back (lumbar area), and runs along the back of the lower limb, reaching the toes.

This compression of the sciatic nerve causes symptoms similar to those of lumbosciatica, but we should not confuse the two, since in the latter case the symptoms would be caused by compression of the sciatic nerve at the level of the spine and not at the level of the buttock.

 

What are the symptoms caused by pyramidal syndrome?

 

Among the main symptoms presented by patients with this neuromuscular condition we highlight the following:

• Throbbing pain in the gluteal area.
• Numbness or tingling sensation in the buttock area and along the back of the lower limb.
• Pain that increases in the sitting position.
• Pain that worsens with activity (walking, running, standing for prolonged periods of time, etc.).
• Pain that increases with certain positions, such as sitting cross-legged or going up and down stairs.
• Mobility of the hip is reduced due to excess stress and the pain that comes with it.

 

 

How can we prevent pyramidal syndrome?

 

Pyramidal syndrome can be prevented, but to do so we must take into account a series of recommendations that will help us to avoid the appearance of this condition:

• Maintain correct postural hygiene. This becomes especially important if our day-to-day lives require us to sit for long periods of time.
• Strengthen the muscles of the abdominal and lumbar area, as well as the gluteal area.
• Practicing physical exercise on a regular basis.
• Perform a proper warm-up before physical activity, and adequate stretching at the end of it.

Physiotherapy treatment of pyramidal syndrome.

Pyramidal syndrome is a condition that usually responds very well to conservative treatments. Therefore physiotherapy is in most cases the therapeutic option of choice.

There are numerous physical therapy techniques that can be useful in the treatment of pyramidal syndrome. Among them we highlight:

• Massage therapy, both of the pyramidal muscle and of the musculature close to it.
• Dry needling.
• Neurodynamics or mobilization of the sciatic nerve. This technique is useful to free the nerve from possible muscle entrapment that may be causing the symptomatology.
• Here we include stretching of both the pyramidal muscle and all nearby musculature that may be involved.
• Joint manipulations of the lumbopelvic region.
• Therapeutic exercise.