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Posted on June 23, 2016 at 1:07 AM


E' una patologia  in cui è compresso il nervo sciatico a livello del muscolo piriforme. Si tratta di un piccolo muscolo tra piramidale e obliquo situati in profondità nel gluteo, che corre tra il femore e l'ileo. É responsabile della rotazione esterna dell'anca. Puó essere causa di grave dolore del nervo sciatico e di disabilità, soprattutto se non é diagnosticata in tempo. 
Si presenta con dolore profondo in regione glutea che aumenta molto alla palpazione e può distribuirsi lungo il decorso del nervo sciatico. Peggiora con la corsa o dopo stazionamento in posizione seduta per tempi prolungati. In alcuni casi sono presenti anche sintomatologie neurologiche con riduzione della sensibilità e della forza dell’arto coinvolto.
Le cause che possono determinarla possono essere:

  • Stare seduti per lunghi periodi
  • Rimanere seduti con un ampio portafoglio nella tasca posteriore dei pantaloni
  • Movimenti ripetitivi in avanti

  • Ciclismo

  • rigidità delle articolazioni sacro-iliache

  • Piede in pronazione forzata

  • Neurinoma di Morton (piede)
  • Trauma
  • Ipertrofia del muscolo piriforme a causa di un uso eccessivo.

Il trattamento inizialmente è di tipo conservativo, con l'applicazione di ghiaccio e l'evitare  attivitá che scatenino il dolore. Il trattamento ad ultrasuoni può essere utile nel ridurre l'infiammazione della zona. Possono anche essere utili esercizi di stretching per il muscolo piriforme, che contribuiranno a diminuire il dolore.La terapia per la sindrome del piriforme può essere anche di tipo farmacologico o infiltrativa. Nel primo caso si usano degli antinfiammatori e dei miorilassanti, che hanno l’obiettivo soprattutto di ridurre la sensazione dolorosa al gluteo. Nel secondo caso nel muscolo piriforme vengono infiltrati degli anestetici locali e dei corticosteroidi. Dopo la cura, la ripresa dell’attività fisica deve avvenire in modo graduale. Nelle fasi più dolorose può essere utile riposare con un cuscino tra le ginocchia, in modo da creare meno tensione al muscolo.

Categories: MEDICINA

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