The pyramidal syndrome<\/b><\/span>also known as piriformis muscle syndrome<\/b><\/span>, false sciatica<\/b><\/span> o pseudosciatica<\/b><\/span>is a neuromuscular condition caused by compression of the sciatic nerve. compression of the sciatic nerve<\/b><\/span> in its passage through the gluteus. This compression is produced by crossing the canal between the piriformis and piriformis muscles. piriformis<\/b><\/span> (also called piriformis) and superior gemellus<\/b><\/span>due to a contracture<\/b><\/span>, fibrous band<\/b><\/span> o overload<\/b><\/span> of the muscle.<\/p>
\n The pyramidal muscle is located deep in the gluteal region, extending from the sacrum to the femur. Near it runs the sciatic nerve, which originates in the lower back (lumbar area) and runs along the entire posterior part of the lower limb, reaching the toes. <\/p>
\n When this muscle is under tension, it can compress the nerve and cause symptoms similar to those of lumbosciatica, although the origin is different: while true sciatica has its cause in the spine, the pyramidal syndrome occurs at the gluteal level<\/b><\/span>.<\/p>
\n Both pathologies share symptoms such as pain radiating down the leg, but differ in their cause and location:<\/p>
\n – Pyramidal syndrome<\/b><\/span>The compression of the sciatic nerve occurs outside the spine, specifically between the pyramidal and superior gemellus muscles, in the gluteal region.<\/p>
\n – Sciatica<\/b><\/span>Compression occurs at the vertebral level, usually due to a herniated disc. herniated disc<\/b><\/span> or due to degenerative processes<\/b><\/span> affecting the intervertebral discs.<\/p>
\n The pain of pyramidal syndrome is usually increase in the sitting position and with movements such as crossing legs or going up and down stairs, while in sciatica<\/b><\/span> (sitting) and with movements such as crossing the legs or going up and down stairs, while in sciatica, the symptoms usually depend more on posture and the condition of the spine.<\/p>
\n It is estimated that pyramidal syndrome is responsible for more than 65% of cases of chronic non 65% of the cases of chronic non-disc lumbociatica<\/b><\/span>i.e. pain radiating down the leg that does not originate in the vertebral discs.<\/p>
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\n Among the main symptoms presented by patients with this neuromuscular condition we highlight the following:<\/p>
\n – Throbbing pain in the gluteal area.<\/p>
\n – Numbness or tingling sensation in the buttock area and along the back of the lower limb.<\/p>
\n – Pain that increases in the sitting position.<\/p>
\n – Pain that worsens with activity (walking, running, standing for prolonged periods of time, etc.).<\/p>
\n – Pain that increases with certain positions, such as sitting cross-legged or going up and down stairs.<\/p>
\n – Reduced hip mobility due to excess tension and pain.<\/p>
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\n The diagnosis of pyramidal syndrome is clinical<\/b><\/span>that is, it is based on the clinical history, signs and symptoms, and physical examination of the patient. Complementary tests such as magnetic resonance imaging may be used, but their function is usually to rule out other pathologies<\/b><\/span>The role of MRI is to rule out other pathologies, as it does not usually provide conclusive findings on the pyramidal muscle. <\/p>
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\n Pyramidal syndrome can be prevented with a combination of good postural habits and adequate physical exercise. Recommendations: <\/p>
\n – Postural hygiene<\/b><\/span>Postural hygiene: essential for people who spend many hours sitting down.<\/p>
\n – <\/span>Strengthening of the abdominal, lumbar and<\/b> abdominal, lumbar and gluteal muscles.<\/span><\/p>
\n – <\/span>Regular physical exercise<\/b>.<\/span><\/p>
\n – <\/span>Pre-heating<\/b> y <\/span>stretching after<\/b> physical activity.<\/span><\/p>
\n In particular, it is recommended to establish a routine of about 15 minutes, two or three times a day<\/b><\/span>focusing on stretching the gluteal musculature, the pyramidal muscle, the obturators, the hamstrings and the quadratus lumborum. Gentle and prolonged stretching is ideal both before and after exercise, preventing the muscle from contracting abruptly. <\/p>
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\n The treatment of pyramidal syndrome is aimed at release the compression of the sciatic nerve<\/b><\/span> and alleviate the symptomatology. It can be divided into three approaches: <\/p>
\n Physiotherapeutic treatment<\/b><\/b><\/p>
\n Physiotherapy is, in most cases, the treatment of choice, with good results in conservative management. The most commonly used techniques include: <\/p>
\n – Massage therapy<\/b><\/span> of the pyramidal muscle and the gluteal musculature.<\/p>
\n – Dry needling<\/b><\/span> on trigger points to deactivate contractures.<\/p>
\n – Neurodynamics<\/b><\/span> or mobilization of the sciatic nerve to free it from entrapment.<\/p>
\n – Therapeutic stretching<\/b><\/span> of the pyramidal muscle and associated musculature.<\/p>
\n – Joint manipulations of the lumbopelvic<\/b><\/span> of the lumbopelvic region.<\/p>
\n – <\/span>Personalized therapeutic exercise<\/b>.<\/span><\/p>
\n All these treatments should be performed by qualified professionals and, preferably, under medical indication.<\/p>
\n 2. Medical treatment<\/b><\/b><\/p>
\n When physiotherapeutic treatment is not sufficient, it can be resorted to:<\/p>
\n – Pharmacological treatment<\/b><\/span> to relieve pain and inflammation.<\/p>
\n – Infiltrations<\/b><\/span> local injections to reduce nerve compression.<\/p>
\n – In resistant cases, surgical treatment may be surgical treatment<\/b><\/span>especially if the pain is severe and persistent.<\/p>
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\n At MIVI Health<\/b><\/span> we are experts in the treatment of pain and we approach pyramidal syndrome from a multidisciplinary and holistic approach. multidisciplinary and holistic approach<\/b><\/span>adapted to the needs of each patient. We have a team of professionals specialized in physiotherapy, pain medicine and other disciplines. <\/p>
\n If you have pain or doubts about our treatments, please contact us<\/b><\/span>. We are here to help you. <\/p>
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\nPyramidal syndrome and sciatica: how to distinguish them?<\/b><\/b><\/h2>
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Symptoms of pyramidal syndrome<\/b><\/b><\/h2>
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How is it diagnosed?<\/b><\/b><\/h2>
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How can we prevent pyramidal syndrome?<\/b><\/b><\/h2>
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Treatment of pyramidal syndrome<\/b><\/b><\/h2>
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At MIVI, we approach pain in a comprehensive manner<\/b><\/b><\/h2>
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References<\/h3>
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