Piriformis Syndrome

Synonyms:Tendon insertion irritation, tendon insertion inflammation of the hip rotator.
Location of the greatest pain: The greatest pain is located in the deepest part of the gluteal muscles.
Cause of Pathology:Incorrect loading of the Musculus piriformis, a muscle that rotates the hip joint externally, can lead to a chronic overloading of the muscle (Musculus piriformis) with permanent hardening and vision attachment at the sacrum (Os coccygis) and at the large rolling mound (Trochanter major).
Age:Priformis syndrome can affect any age group. As From clinical experience, younger women and patients often suffer from this disease after the implantation of a hip prosthesis.
Gender:Women > Men
Accident:No
Type of pain: stabbing, pulling
Pain development:Acute increase in pain after physical exertion or internal rotation.
Pain occurrence:Pain usually occurs after exertion. Sometimes also at rest.
External aspects:None
Treatment: mainly conservative methods, such as physiotherapy specifically for Piriformis syndrome

Pain on the outside of the hip

Burning pain, which is located on the outside of the hip or thigh, is often caused by nerve irritation. Various nerves such as the sciatic nerve, the femoral nerve or the obturatorius nerve (as well as some skin nerves) can be responsible for pain in the outer area of the hip. These nerves can either be constricted at the spine or they can be compressed in their course by swollen tissue or muscles.

Common causes of such nerve irritation are external pressure, overweight, fatty tissue, muscle training or clothing that is too tight. However, if the pain on the outside of the hip feels rather dull or boring and improves with movement and heat, this is an indication that the pain originates from the hip muscles. Tense muscles often cause pain that can be precisely localized and is limited to certain points (the tendon attachments of the muscles).

It is important to note that most hip pain on the outside of the hip is not pain of the hip joint itself, but is mostly caused by tense hip muscles and by the connective tissue. Only when tensions last for a long time can painful hip joint damage occur. However, causes for hip pain outside the musculoskeletal system should also be considered.

For example, peripheral arterial occlusive disease of the aortic pelvis type can also cause stabbing muscle pain in the region of the hip, thigh and buttocks. The cause of this vascular disease is vascular calcification (arteriosclerosis), which leads to an undersupply of tissue and thus causes pain. There are many explanations and causes for groin pain.

On the one hand, the hip joint with bones, cartilage, ligaments, muscles, tendons and bursae, all of which can also cause pain in the groin, is located close to the groin. In addition, nerve bottlenecks, spinal and pelvic diseases, as well as internal organs in the groin area (intestine and genital organs) can also cause pain in the groin. The pain in the groin can present itself as a sharp, stabbing pain, but also as a pulling in the groin, a feeling of pressure or as a bump or hernia in the groin (bulge of the abdominal wall).

Pain sensations in the groin can also be triggered by foot malpositions, differences in leg length or postural defects.Such disturbances are usually only ́ ́funktionell ́ ́ and can be reversed. A leg length difference of more than two centimeters, for example, leads to a pointed foot position of the shorter leg and on the longer side to a stronger flexion in the hip and knee. This causes many problems and complaints in the lower half of the body up to the groin.

For this reason, differences in leg length should be compensated for at an early stage by orthopedic aids such as heel elevations and the like in order to prevent chronic pain in the silent area or in the pelvis. Pain that is localized in the depth of the groin and initially only occurs after prolonged exertion such as climbing stairs or cycling and then increasingly when bending the hip joint can be caused by the so-called impingement of the hip. This leads to impingement or an impact of parts of the hip joint with the thigh bone.

The impingement of the hip often affects young men between 20 and 30 years of age. The risk of early wear and tear of the hip joint due to the impingement and the development of arthrosis is increased. Chronic pain in the groin region can be a typical sign of hip arthrosis (joint wear and tear). In addition, osteoarthritis can lead to initial pain in the morning, hip pain especially after exertion, pain at rest (e.g. at night), pain when the leg is turned around its own axis and increasing stiffness.