Understanding and Managing Low Back Pain and Piriformis Syndrome

February 2, 2024

In a recent study, Professor Ts. Dr. Wong Ling Shing, a distinguished professor and Pro Vice-Chancellor from the Faculty of Health and Life Sciences at INTI International University, has made significant progress in understanding the link between Low Back Pain (LBP) and Piriformis Syndrome (PS). Prof. Wong’s research aimed to clarify the intricate connections between the thickness of the piriformis muscle and the functionality of the gluteus muscles, addressing crucial gaps in our understanding of these common conditions.

LBP is a condition that causes discomfort in the area spanning from the lower edge of the ribs to the buttock. It can be quite challenging for individuals, as it hinders movement and adversely affects their quality of life and mental health. LBP can also restrict one’s ability to work and engage with family and friends. Globally, it affects around 37% of people who experience monthly recurrences. In Malaysia, the incidence rates of LBP are notably high, reaching up to 60% among commercial vehicle drivers and up to 68% among medical students, as highlighted by Prof. Wong.

Piriformis Syndrome is a condition that causes a spasm in the piriformis muscle, located deep within the buttock. This can result in pain in the buttock area and aggravate the sciatic nerve, causing pain, numbness, and tingling down the back of the thigh and leg. The symptoms usually affect one side of the body and can worsen with prolonged sitting or hip-engaging activities like stair climbing or walking. In Malaysia, an estimated 17.2% of people who suffer from chronic buttock pain and LBP are diagnosed with PS, which highlights its significant impact as a primary cause of sciatica, buttock pain, and LBP, despite its varied prevalence (ranging from 0.3% to 36%).

Professor Ts. Dr Wong Ling Shing, who is the Pro Vice-Chancellor of INTI International University and a senior lecturer at the Faculty of Health and Life Sciences, conducted a research study on the complex relationship between Low Back Pain (LBP) and Piriformis Syndrome (PS) to identify the connections between the thickness of the piriformis muscle, the functioning of gluteus muscles, and the management of PS and LBP.

Prof. Wong’s research sheds light on the complex nature of piriformis syndrome and its various diagnostic criteria, emphasising the impact of age, gender, and occupational factors on its prevalence. The study introduces innovative insights into muscle activation in hip extensor and rotator muscles in relation to piriformis thickness during activities such as prone lying and single-leg standing.

“This research aims to investigate the relationship between piriformis muscle thickness and gluteus muscle functions in patients with low back pain with and without piriformis syndrome, aiming to fill existing gaps in our understanding,” stated Prof. Wong.

The discovery of an inverse relationship between the thickness of the piriformis muscle and the strength of the gluteus maximus is valuable information for healthcare practitioners. This information can help manage PS and LBP more effectively. The study suggests that people with PS may rely more on the gluteus medius than the gluteus maximus for stability. This could help clinicians develop more precise and effective management strategies for PS by addressing the differences in interactions between the piriformis and gluteus muscles.

It is crucial to seek proper treatment for Piriformis Syndrome, as leaving it untreated can result in disability and a lower quality of life. The study highlights the importance of starting an exercise routine as a critical relief strategy, and it is essential to adhere to it to prevent the recurrence of symptoms. Additionally, the research emphasises the significance of avoiding prolonged periods of sitting as a crucial aspect of effectively managing the condition.