Diagnosis of Piriformis syndrome in pregnancy
In pregnant women with severe pain in the hip or buttock region, the doctor makes the diagnosis through the medical history. During the physical examination, the doctor can perform various functional tests of the hip joint and the muscles. Characteristic for the Piriformis syndrome is pain when bending the leg and during internal rotation.
In addition, the leg is weak and weakened on the affected side. Imaging procedures such as an MRI or CT serve to exclude other causes and to confirm the diagnosis. However, there is no precise test for the specific detection of nerve compression.
However, various functional tests of the gluteal and thigh muscles can provide indications of the presence of piriformis syndrome in pregnant women. The examining doctor checks whether the woman can move the stretched thigh outwards or inwards and feel pain. Pain when lifting the stretched leg and during internal rotation can also be caused by Piriformis syndrome.
Treatment of piriformis syndrome in pregnancy
Treatment of piriformis syndrome in pregnancy is done by sparing and immobilizing the baby. Long periods of sitting and strenuous activities, such as long walks and standing for long periods, should be avoided. In addition, the pregnant woman should not lift heavily, as this increases the pressure on the piriformis muscle and the pain becomes worse.
Cooling the painful area with a cooling pad or treatment with a hot-water bottle can also alleviate the pain. After the diagnosis, the doctor can refer the pregnant woman to a physiotherapist. Regular stretching and exercises to strengthen the hip and buttock muscles lead to an improvement of the complaints.
The exercises should be performed 2 to 3 times a week. If the symptoms are severe, the doctor may prescribe painkillers.During pregnancy, however, not all medications are allowed and those affected should always consult their doctor about the exact choice and dosage of the preparations. Ibuprofen (administration only permitted in the 1st and 2nd trimester) and paracetamol are considered to be well tolerated by pregnant women and do not carry any known risk of embryo malformation.
Certain exercises can alleviate the pain of piriformis syndrome during pregnancy. Which exercises are best for the pregnant woman depends on the week of pregnancy and is best discussed with the treating physician. One possibility is to stretch the thigh muscles: while sitting, one leg is brought forward and the knee joint is bent at right angles.
The other leg is stretched straight backwards until the stretch is felt in the bent leg. Another possibility is for the pregnant woman to lie on her back, bend the legs and place the left leg on the knee of the right one. Then the right leg is pulled towards the abdomen below the knee until a noticeable stretch is felt in the buttocks.
With a fascial roll, the tension in the gluteal muscles can be loosened additionally. The massage promotes the blood circulation of the connective tissue and makes the muscles supple again. Stretching exercises for piriformis syndrome?both a treatment with heat or cold can improve the symptoms and relieve the pain.
Whether heat or cold helps better, each pregnant woman must try it out for herself. However, the hot-water bottle or cooling pad should not be placed directly on the pregnant abdomen, but on the painful point on the buttocks. It is not a problem, however, if the cooling pad lies on the stomach for a short time, as the blood circulation in the stomach is very good and the baby is thus protected from the cold.
The amniotic fluid also compensates well for short-term temperature fluctuations. Care should be taken with a hot-water bottle, however, as excessive heat can overheat the baby. The more advanced the pregnancy is, the more the baby lies directly behind the abdominal wall and quickly absorbs the heat.
