Pear-shaped muscle and back pain
Last reviewed: 23.04.2024
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Pear-shaped muscle - m. Piriformis
With the leg free from support, the pear-shaped muscle shows a great strength: by contracting it, you can turn the thigh outward. Retracts the 90 ° bent femur.
- Beginning: Facies pelvina sacrum
- Attachment: Peak Trochanter major.
- Innervation: spinal nerves S1-S3 - sacral plexus - rr. Musculares.
Diagnostics
Trigger zones are more often localized: in the lateral part of the muscle; in the medial part of the muscle near the sacrum. The study of the muscle group of the lateral rotators of the thigh is complicated by the fact that they lie under the large gluteus muscle. Pear-shaped muscle can be examined along its entire length, and the medial end is available for almost direct examination through the rectum or vagina. The localization of the pear-shaped muscle is determined by external examination of the pear-shaped line from the large spit to the cranial edge of the large sciatic foramen. When the gluteal mouse is relaxed, a large spit can be determined using deep circular palpation of the lateral surface of the thigh. The inner edge of the large sciatic opening along the lateral edge of the sacrum can be palpated through the relaxed large gluteal muscle downward from the posterior lower iliac spine. Trigger zones of the lateral part of the muscle are usually located on the border of the middle and lateral third of the pear-shaped muscle. These trigger zones are only available for external palpation. The trigger zone of the medial part of the muscle manifests a marked morbidity with the pressure in the medial direction in the region of the large sciatic foramen. In the study of the pelvis, these medial trigger zones are more painful. When doubting the presence of trigger zones, a vaginal or rectal examination should be performed.
[4]
Reflected pain
Most of the pain is reflected in the sacroiliac region, buttock and behind the hip joint. Sometimes the pain extends to the upper two thirds of the hamstrings. The pain pattern from the trigger zones of the lateral and medial parts of the muscle is the same.