Pear-shaped muscle syndrome: symptoms, treatment, exercises

Pear-shaped muscle syndrome

Pear-shaped muscle syndrome is a combination of pain that occurs in the buttock zone.Their appearance may be associated with a variety of phenomena from unsuccessful injections of drugs into this area to pelvic organs.

For this pathology, the manifestation in the zone of the buttocks of severe pain with subsequent spread to the lower extremities (the pear-shaped muscle itself is represented in the first illustration to the article).

Let us consider in more detail what is this syndrome, what manifestations it is characterized and how to cure it.

Pear-shaped muscle - what is it?

This body looks like a triangle, which starts from the anterior surface of the sacrum.

The muscle fibers of the pear-shaped muscle, converting, pass through a large sciatic hole from the pelvic cavity and pass into the tendon that is attached to the surface of the large trochanter of the thigh.

As a result of the fact that they only partially occupy the sciatic hole, an upper and lower gap is formed in which the nerve and the gluteal artery are located.

In 90 percent of cases, the trunk of the sciatic nerve from the pelvic cavity under the pear-shaped muscle extends into the gluteal region, and in 10 percent it passes through it.

For this reason, compaction of the pear-shaped muscle tissue is a prerequisite for compression of the sciatic nerve and the emergence of irradiating, painful pains.

Symptomatology

Identify the syndrome of the pear-shaped muscle is possible only if there are complaints about aching, pulling pains in the buttock, which, when loaded, become even more intense and stronger.

Symptoms of this disease depend on what was being squeezed: the vessels responsible for supplying nutritional elements to the artery or the nerve itself.

Consider the most common signs of this syndrome:

• Symptom Bonnet-Bobrovnikova. It is characterized by the manifestation of pain in the gluteal region, when the patient's leg is fixed as follows way: the person lies in a relaxed state on the back, his leg is bent in the hip and knee joints.
• Strong, aching pain. Patients experience a pulling feeling in the muscles, which most often appears when in an upright position for a long period of time. The soreness of sensations in this syndrome is slightly dulled when the patient sits down or lies down.
• Unpleasant sensations in the region of the ischium. They are referred to the symptoms of pear-shaped muscle syndrome, if their appearance is associated with palpation near the ischial hillock.
• Pathology of the pelvic floor. Overexertion, which persists for a very long time, can indicate the defeat of the pear-shaped and other muscles located in this area, and also cause painful sensations.
• Symptom of Vilenkin. It is characterized by the appearance of pain when tapping on the back of the foot.

In case the disease touched the sub-necked region, pear-shaped muscle syndrome may have the following symptoms:

1. aching sensations in the muscles of the lower limbs;
2. the spread of pain, their deterioration in stressful situations, with climate change, etc .;
3. pain syndrome in the shin area after walking;
4. a decrease in sensitivity when touched by the skin.

Causes

The location of the pear-shaped muscle is the primary factor affecting the development of this syndrome, prolonged tonic stress squeezing the surrounding neurological-vascular structures.

In medical practice, the pear-shaped muscle syndrome most often occurs against the background of excessive load of this organ and pathologies of the pelvic organs. Among the other causes of the appearance of this disease are the following:

• supercooling;
• overtraining of muscles;
• spine injury;
• diseases of the sacroiliac joint;
• lumbar stenosis;
• unsuccessful injection of medicines into the pear-shaped muscle;
• gynecological pathologies;
• trauma gluteal or lumbosacral region.

Diagnostics

The difficulty in diagnosing this disease lies in the fact that in many cases the pain is limited and involves a certain position of the patient's body. Therefore, in the first place, it is well to know what signs and manifestations of pear-shaped muscle syndrome.

If you notice a manifestation of the above symptoms, you should immediately consult a doctor. Correct and timely treatment for this syndrome is the key to a quick recovery.

The main part of the diagnosis of this disease is based on manual tests: palpation a sacro-spine ligament, a sacroiliac joint, a pear-shaped muscle, as well as tapping a sick buttock.

With the help of such a feeling, it is possible to identify the compaction of muscle tissues.

Also, the diagnosis of pear-shaped muscle syndrome helps to take into account the states preceding the disease: traumatic injuries, overvoltage, hypothermia, etc.

No less important diagnostic tests are novocaine injection, computed tomography, X-ray and magnetic resonance imaging.

Treatment of the syndrome

The algorithm of treatment of this syndrome is similar to the elimination of pain, which is associated with squeezing the sciatic nerve, as well as the nerve roots of the lumbosacral spine.

Syndrome pear-shaped muscle should not be considered as a local manifestation of pain.

Produced treatment should be directed not only to improving the patient's well-being, but also to exclude the reasons that triggered the development of this pathology.

1. laseropuncture;
2. pharmacopuncture;
3. massotherapy;
4. Exercise therapy and special exercises;
5. acupuncture;
6. physiotherapy;
7. vacuum therapy.

Complex and systematic approach to the treatment of this syndrome allows to eliminate it in a short time, forgetting about discomfort and pain forever.

The role of massage in the treatment of disease

Along with medicamentous drugs, doctors prescribe a course of therapeutic massage in the pear-shaped muscle syndrome.This method of treatment is most effective in the early stages of the disease.

Massage begins with kneading of the near-vertebral region with the subsequent transition to the lumbosacral zone.

It is important to remember that such an effect can not always lead to a positive effect, therefore such procedures should be performed under the supervision of the attending physician.

Immediately produce a buttock massage on the sore side, then proceed to the back surface of the foot. Its average duration varies within 15-20 minutes. For visible improvement of the condition, it is recommended to perform 12 to 20 massage procedures, and a month later, repeat this course.

Treatment reflex-segmental or acupressure helps to speed recovery of the patient, removal of pain. As a conclusion, massage is an excellent addition to the basic medical therapy.

Physiotherapy

LFK or gymnastic exercises are an integral part of the treatment of this disease. They effectively reduce pain, relax muscle tissue and significantly improve the patient's well-being.

LFK can also be practiced at home, having previously learned how to do the exercises correctly.

Remember, to avoid injury, exercise should be done carefully, not at full strength and do not drive the movement to pain.

Let's consider some universal exercises:

• Exercise number 1. Lie on your back on a hard surface, bend your knees, place your feet on the width of your shoulders. Slowly reduce and dilute your knees. Breed knees should be as strong as it is for you painlessly.
• Exercise number 2. Lying on your back, put your feet on the floor, bend them in the lap, connect the feet and knees together. Slowly and gently tilt your knees one way, then the other.
• Exercise number 3. Stand on all fours. Bend the leg in the knee, take it to the side, and then carefully straighten it, return the leg back to its original position in the reverse order. Repeat for the other leg.
• Exercise 4. Sit on a chair, so that the body with legs formed angles of 90 degrees, put a sore leg on a healthy knee. Slowly, not bending your back, make a tilt with your body forward to your knees.

LFK and massage in combination with taking medications is the most effective way to treat this pathology. But do not forget that in order to avoid the opposite effect, all procedures must be previously agreed with the attending physician.

A source: http://prosindrom.com/neurological/sindrom-grushevidnoj-myshtsy.html

Pear-shaped muscle syndrome - treatment at home

The syndrome of the pear-shaped muscle is manifested by sharp pains in the region of the buttocks, sometimes they can be given to the genitals, hips and even the shins.

The reasons for the development of pathology doctors can not specify exactly, therefore in each case, a strict individual diagnosis, and only after that it is possible to start treating the syndrome of pear-shaped muscle in the home conditions.

First you need to understand the causes of the disease, remove painful spasms, and then proceed to restore the affected tissue.

Most often, the syndrome occurs in people with diagnosed lumbosacral radiculitis of a discogenic nature.

Methods of treatment of pear-shaped muscle

In the approach to the elimination of pain and pinching of the pear-shaped muscle, it is important to take into account not so much the effectiveness of certain home methods as their combination with medical therapy.

How long the syndrome will be treated depends directly on the patient's activity and his desire to get rid of the pain.

If he competently combines all the proposed methods, including medicines, exercise therapy, all kinds of necessary massage and folk recipes, then the recovery will not take more than 1-2 months.

Pear-shaped muscle syndrome - massage treatment

The importance of massage in the treatment of the syndrome

The course of therapeutic massage is appointed by a therapist who deals with the disease. This method is particularly effective for treating the first stages of the disease.

The session in both home and outpatient conditions lasts an average of 20 minutes. To achieve the necessary results, it is recommended to take a course of 12-20 procedures with a repetition in a month.

Self-massage is conducted at home regularly, without the use of additional devices. The only thing that can be needed is a comfortable floor mat.

Do it on a hard surface:

• Lie down on your side, massage the gluteus muscle with your thumb;
• pay special attention to painful areas and compaction points;
• The leg in the knee joint needs to be bent slightly, so that the muscle stretches;
• You can use a tennis ball - the patient lies on his side, glides sideways on the ball;
• the ball is located in the area of ​​painful zones.

Massage should be slow and smooth, without sharp pressure. Its direction should be down, along the muscle fibers. Sensations of numbness and tingling when moving the sword suggest that the sciatic nerve was hurt.

If the inflammatory process develops, the massage can be limited by circular motions in the hip joint from the side of the lesion. Hands move arbitrarily. Repeat warm-up every 4 hours.

Stretching with relaxation should also be done by a doctor. The power of turns and all pressure is strictly controlled by a specialist, there should be no pain.

Use of medicines

Here, what medications can be treated with pear-shaped muscle syndrome:

1. Anesthetics. Apply non-steroidal anti-inflammatory drugs. Their goal is to block pain and inflammation. Often appoint intramuscular forms, as they penetrate better and affect the affected fibers. Drugs based on diclofenac, meloxicam, ketorolac are popular.
2. Analgesics slightly worse affect the problem, suggesting only the elimination of pain, - "Tempalgin "Bral "Baralgin" and other means based on metamizol sodium.
3. Spasmolytics. Means prescribe to block spasms. Drugs commonly used are drotaverine. You can use products in the form of tablets or injections.
4. Muscle relaxants. Assigned if antispasmodics do not give the proper effect. The drugs relax the spasms of the muscles. The most common product is "Midokalm".
5. Implementation of the blockade. Use an anesthetic solution such as lidocaine or novocaine. They have increased effectiveness in the fight against very severe pain.

With medication, it is impossible to completely treat the problem. In addition to this method and massage perform special gymnastics.

Basic exercises with the syndrome

The goal of therapeutic gymnastics with inflammation of the muscle is to eliminate tension, increase the elasticity of the ligaments and improve the mobility of the hip area. It also helps to get rid of severe pain.

At home, you can do the following exercises with pear-shaped muscle syndrome:

1. They lay on their backs and flex their legs slightly at the knees. They lead and spread their knees to the sides, stretching their muscles.
2. Take a sitting position, legs are laid on top of each other. They sit for 5 minutes, slightly stretching their socks, change their legs.
3. Sit on a chair and put your feet at an angle of 90 degrees. Stand up, without parting your knees, and straighten up completely, then relax.
4. Again, sit on a chair and put your feet on top of each other. Lie down on the leg, repeat 5-20 times.
5. Take a pose on all fours. Straighten one leg, trying to stretch the muscles of the hip joint and ligaments, repeat the 3 approaches with each leg.
6. Lie on your stomach and reduce your legs. Within 5 seconds, push one knee to the other.
7. Lie on your back and stretch out your arms. Raise your legs and bend at the knees. Legs start in the opposite direction to the maximum. Blades are not torn off. Repeat 5 times.

Exercise is necessary every day 3-4 times. They will not take more than 15 minutes of time.

Folk recipes

If you want to use folk remedies to treat pear-shaped muscle syndrome, remember that their application should also be coordinated with a doctor.

High efficiency is possessed by ointments, tinctures and means for grinding:

1. Amanita. To prepare tinctures, take fresh fly agarics, wash them and put them in a jar. Top up with vodka. Insist for a week. Can be used in the form of compresses for 7 days.
2. Analgin and hawthorn. Tincture of 200 g of triple cologne, 30 ml of hawthorn and valerian, 10 tablets of analgin and 50 ml of tincture of red pepper infused for 24 hours. Rubbed 3 times a day in a sore spot.
3. Horse Chestnut. B, l of wine alcohol soaked 50 g of dried horse chestnut. Gauze soaked and put on the night. Repeat 10 days.
4. Ointment from turpentine. Take 1 tbsp. l. turpentine and protein. Stir, apply to the tissue and apply to a sore spot. It is advisable to wear before the burning, change 2 times a day.
5. Horseradish ointment. Rub the root in an amount of 2 tbsp. l. and mixed with 1 tbsp. l. honey. Apply on gauze and apply for 4 hours.
6. Kerosene and salt. About 1 tbsp. l. Honey is mixed with 1 tbsp. l. kerosene and salt, apply to the tissue, and then to the diseased area. Keep it 2-3 hours.
7. Butter. About 1 tbsp. l. Soft oil is mixed with honey and birch tar. Apply at night.
8. Flowers of calyx and thyme with calendula. Take 50 g of each herb, mix, 2 tbsp. l. Collect hot water. After an hour, filter, drink 1/3 cup 3 times a day.

A competent combination of all recipes, drugs and mechanical actions under the supervision of a doctor will lead to a rapid recovery.

When using folk recipes, it is also important to consider that they can be addictive and lose effectiveness.Do not be treated 1 way for a month or more, change the procedure!

A source: http://lechenie-narodom.ru/sindrom-grushevidnoj-myshtsy-lechenie-v-domashnih-usloviyah/

Pear-shaped muscle syndrome - causes of the disease

Pain syndrome, the location of which is located in the buttocks, with the possible spread of pain to the groin, upper thigh and lower leg, was called "pear-shaped muscle syndrome." It can be found in almost half of people suffering from discogenic lumbosacral radiculitis. This syndrome is often caused by a pinch of the sciatic nerve.

Causes of the syndrome

Source of pain - inflamed muscle

There are primary and secondary causes of this disease.

The immediate causes that lead to the development of the primary form of the syndrome include stretching, trauma in the lumbar region and buttocks, muscular overstrain, long stay in one position, hypothermia, incorrectly injected medication and some others factors.

There is also a secondary syndrome, the causes of which are various diseases of the pelvic organs and the sacral region, not directly associated with osteochondrosis.

The reasons for the development of the syndrome can also be divided into vertebrogenic (caused by vertebrogenic pathology) and non-embryogenic.

Injuries and tumors on the spine and spinal roots, lumbar stenosis, pinching of L1-S1 rootlets are vertebrogenic causes.

To non-cerebrovascular reasons include myofascial pain syndrome, as well as pain, which are caused by various diseases of internal organs.

Manifestations of the disease

With a disease such as pear-shaped muscle syndrome, the symptoms are divided into three groups:

• local symptoms;
• signs of compression of the sciatic nerve;
• signs of compression of arteries and vessels.

Local signs of the syndrome can be manifested by such phenomena:

• pain in the buttock of a pulling or aching character. Pain can give to the hip and sacroiliac joints, while increasing during walking, with prolonged stays in a standing position or in a semi-squat;
• pain decreases when lying down;
• in the relaxed state of the gluteus maximus, you can feel the tense pear-shaped muscle;
• when tapping the pear-shaped muscle, pain is given to the posterior surface of the foot;
• while holding a finger from the ischial hillock upward, soreness of the sciatic awn is felt;
• The tension of the pear-shaped muscle is often combined with the tension of other muscles of the pelvic floor.

On the infringement of the sciatic nerve and compression of the vessels in the subgranular space they say:

• pains of stupid character, accompanied by a feeling of stiffness, burning or chilliness;
• pain manifests itself after the transfer of stressful situations, weather changes;
• a decrease in the Achilles reflex;
• when only the fibers that form the tibial nerve are involved, the pain sensations are localized in the calf muscles in the back part.

Signs of compression of the vessels of the sciatic nerve and squeezing the gluteal artery:

• pallor of the skin on the leg;
• a sharply arising spasm of the vessels of the leg, as a result of which lameness arises. At a spasm in order to continue walking to the patient you need to rest, change the position of your legs (sit or lie down) and only after that he will be able to move on. As a rule, seizures are repeated periodically.

How is the patient examined?

The main test, which allows you to accurately diagnose pear-shaped muscle syndrome, is considered to be a novocaine injection in the pear-shaped muscle. The estimation of positive shifts arising under the influence of an anesthetic preparation is made.

Also for diagnosing this syndrome, physicians perform the following manual tests:

• palpation of the upper inner part of the large trochanter of the thigh (feeling the place of attachment of the strained pear-shaped muscle);
• palpation of the sacroiliac joint;
• testing sacro-spinal cord;
• tapping on the sore side of the buttocks.

Treatment of the syndrome

Scheme of pear-shaped muscle and muscles near it

With a disease such as pear-shaped muscle syndrome, the treatment is similar to the treatment algorithm for painful sensations associated with infringement of nerve endings in the lumbosacral part of the spine (vetotonizing, anti-inflammatory and analgesic preparations). It should not be considered that this pain syndrome is a local manifestation of pain. Treatment should be aimed not only at eliminating unpleasant sensations, it should exclude directly the cause that contributes to the development of the disease.

How to treat the syndrome of pear-shaped muscle, the patient will be able to tell only the doctor.

In addition to drug therapy aimed at the removal of muscle spasm and anesthesia, it is necessary to use a variety of reflex methods.

The specialist will pick you a set of procedures, which can include acupuncture, pharmaceutical or laser acupuncture, vacuum therapy, medical gymnastics, etc.

It is very important to seek medical help on time and undergo a complete examination to exclude or confirm the presence of concomitant pathologies.

Then, choosing a complex therapy, you can expect a favorable outcome of the disease.

If the treatment is started in time and directed directly to eliminate the cause of the disease, the condition should be improved after a few days from the start of treatment.

Gymnastic Exercises

If there is a pear-shaped muscle syndrome, exercises should be done to relax the pear-shaped muscle and activate its antagonists. Carry out the exercises in the order in which they are indicated.

1. Lie on your back, bend your legs in half, lean against the soles of the couch. Smoothly connect and spread the knees. Connect the half-bent legs and vigorously push the knees one another for a few seconds.
2. In the sitting position, place your feet wide, knee joints, pull out one hand and lean against the couch with your palm, start to get up from the couch. When the palm of the supporting arm starts to break away from the couch, give the second hand to the assistant, so that he helps to straighten your body. Connected knees need to be severed.
3. When the condition improves, periodically for a few minutes, sit with your foot on your leg.

A source: https://vashaspina.ru/sindrom-grushevidnoj-myshcy/

Pear-shaped muscle syndrome: symptoms and treatment

Pear-shaped muscle syndrome is one of the most common causes of persistent pain syndrome.

Its signs are present in more than half of patients with dorsopathy of the lumbosacral department.

But often this syndrome remains timely not diagnosed, which significantly delays the treatment period and leads to the appointment of a significant number of different drugs.

What is the essence of the syndrome

Pear-shaped muscle syndrome refers to compression-ischemic tunneling neuropathies.

Its key manifestations are caused by the compression of the trunk of the sciatic nerve and the vessels that come with it in the so-called subgranular aperture (space).

And as the main factor of compression is a spastic and altered pear-shaped muscle.

The paired subclavicular opening is located in the gluteal region and is the lower part of the large sciatic hole of the pelvis. Anatomically it has a slit-shaped shape and is limited by a sacro-tuberous ligament, the lower edge of the pear-shaped muscle (m. piriformis) and the upper twin muscle (m.

gemellus superior). Through the subclavicular opening from the pelvic cavity into the deep gluteal space, the sciatic nerve, the posterior cutaneous nerve of the femur, the lower gluteal and vaginal (sexual) vascular-neural bundles exit. They have fascial cases, but they can not withstand external compression.

A pathological permanent contraction of the pear-shaped muscle is accompanied by a thickening of its abdomen, which leads to a substantial narrowing of the sub-tubular orifice.

In this case, the greatest clinical significance is the compression of the trunk of the sciatic nerve. It is neuropathy and is the reason for patients to consult a doctor.

The sciatic nerve can also pass through the abdomen of the pear-shaped muscle. Its compression with such a rare anatomical variant is usually not combined with compression of other vascular-neural bundles in the sub-necked space.

Etiology

Pear-shaped muscle syndrome by the mechanism of development can be primary and secondary, when the muscular-tonic syndrome occurs due to other pathological conditions. The share of secondary disorders accounts for more than 80% of clinical cases.

As a reason for the development of pear-shaped muscle syndrome, the following can occur:

• Long-term preservation of the non-physiological posture with asymmetric overload of the pelvic-iliac muscle group. This is possible with an incorrectly organized workplace, forced position of the limbs and pelvis in case of their illiterate fixation after injuries. Spasm of the pear-shaped muscle also often develops in the antalgic posture in the case of vertebrogenic radicular syndrome.
• Injuries of the lumbosacral and pelvic areas leading to stretching or damage (tearing) of the pear-shaped muscle or to the formation of compression hematoma.
• Vertebrogenic pathology (osteochondrosis with lesion of the lumbosacral spine, spine tumors and paravertebral structures, lumbar stenosis and other lumbosacral dorsopathies). In this spasm pear-shaped muscle is a manifestation of the muscular-tonic syndrome and can have a reflex or radicular nature.
• Sacroiliitis of any etiology.
• Syndrome of twisted and skewed pelvis of various origin. It can occur with different lengths of limbs (in the absence of sufficient orthopedic correction), S-shaped scoliosis, pathology of the hip joints.
• Overtraining of the muscle, which develops due to irrational excess loads on the gluteal muscle group and the absence of a rest period between power training.
• Ossifying myositis.
• Infectious and inflammatory diseases of the pelvic organs, leading to reflex spasm of the muscle. The most likely cause is gynecological pathology.

To the infrequent causes of pear-shaped muscle syndrome include a technically incorrectly administered intramuscular injection, hypothermia.

Pathogenesis

The spasm of the muscle is accompanied not only by its shortening and thickening, although this leads to a narrowing of the sub-tubular orifice with the compression of nerves and vessels. Of great importance are other pathological changes.

In the pathologically strained muscle, multiple micro-damaging of the fibers occurs and under-oxidized exchange products accumulate.

In response to this, mediators of inflammation begin to be produced, the permeability of small vessels increases, aseptic inflammation and tissue inducing develop.

In this process, the pelvic floor muscles are often involved, which can aggravate the pain syndrome and cause mild sphincter dysfunction.

In addition, inflammatory mediators contribute to local changes in the sciatic nerve sheath, enhancing the manifestations of his compression neuropathy.

Clinical picture

The main symptom of pear-shaped muscle syndrome is persistent and often resistant to treatment pain.

It has several pathogenetic mechanisms and is usually combined with other clinical manifestations.

In this case, the pain syndrome in two thirds of cases debuted with lumbargia (low back pain), which within 2 weeks is transformed into ischialgia (pain associated with sciatic nerve damage).

The syndrome of the pear-shaped muscle consists of several groups of symptoms:

• Local - associated directly with the spasm of the pear-shaped muscle. Their detection allows for differential diagnosis between pear-shaped muscle syndrome and vertebrogenic pain syndrome.
• Neuropathic - associated with compression of the sciatic nerve. This includes characteristic sciatica, sensory, vegetative and motor disorders in the lower limb on the side of spasm of the pear-shaped muscle.
• Vascular symptoms are caused by squeezing the gluteal artery and other vessels passing through the sub-tubus orifice.

Spasmodic muscle gives a constant pain in the gluteal region of the sagging, aching, painful, cerebral character.

Some patients, as the site of greatest soreness, indicate areas of the sacroiliac joint and hip joint, which can lead to an incorrect diagnostic search.

Walking, bringing the hip, trying to put a foot on the leg, squatting are accompanied by increased discomfort.

Such pain is supplemented by ischialgia. In this case, the patients note lumbago and constant cerebral sensations on the back of the thigh, accompanied by a feeling of chilliness or burning, a feeling of numbness or stiffness, crawling creepy.

Pain due to compression of the sciatic nerve can also be localized in the innervation zone of its main branches - tibial or peroneal nerves.

In this case, patients can complain of unpleasant sensations in the lower leg and foot, which increase with changing weather, walking, in stressful situations.

The motor manifestations of pear-shaped muscle syndrome include paresis of the leg and foot muscles. Their localization and combination depend on which fibers of the sciatic nerve were subjected to compression. With severe neuropathy, even the appearance of a "dangling "horse" or "heel" foot is possible.

The vascular component of pear-shaped muscle syndrome is, first of all, intermittent claudication. Moreover, it is associated not only with the compression of the arteries in the subgranular space, as previously thought.

The main role in the development of such transient ischemia is played by spasm of middle and small caliber arteries, caused by the damage of postganglionic sympathetic fibers in the sciatic nerve.

In addition to intermittent claudication, there is numbness and coldness of the fingers on the foot, blanching of the skin of the foot.

Thus there are pauses before the beginning of an emiction, unpleasant sensations at a defecation, a dyspareunia (a dyscomfort and a pain in genitals at the sexual certificate or act).

Diagnostics and tests

Examining the patient, the doctor conducts a series of tests that allow suspected pear-shaped muscle syndrome.

Diagnosis of pear-shaped muscle syndrome consists of physical examination data and the results of additional instrumental research methods.

The key signs of this syndrome are:

• Defined palpator under the thickness of the gluteal muscles is a painful, dense, heavy pear-shaped muscle. Her condition can also be assessed by transrectal examination.
• Soreness in the areas of attachment of the pear-shaped muscle - along the upper inner region of the large trochanter and the lower part of the sacroiliac joint.
• The positive symptom of Freiberg is the appearance of pain when rotating inside a bent hip.
• Positive symptom Beattie (Beatti) - the appearance of pain when trying to lift the knee, lying on a healthy side.
• Positive Pace symptom is soreness in flexion, adduction and internal rotation of the thigh. It is also called the SAVR test.
• Positive test Mirkin, for which the patient is asked to slowly bend forward from the standing position without bending the knees. Pressing on the buttock in the projection area of ​​the exit of the sciatic nerve from under the pear-shaped muscle leads to the appearance of pain.
• A positive symptom Bonnet-Bobrovnikova - pain with passive reduction and rotation inside the hip.
• Positive symptom of Grossman (spasmodic contraction of the gluteal muscles when pokolachivanii on the upper and lower lumbar spine).
• Appearance of pain along the sciatic nerve when pokolachivanii on the buttock.

As a diagnostic test, injection of novocaine into the pear-shaped muscle is also used. Significant relief of pain is a symptom indicative of clinically significant spasm.

For additional examination of the patient, EMG is used (for detecting neuropathic and myopathic components), CT / MRI, radiography. But the main role in the everyday diagnosis of pear-shaped muscle syndrome is still assigned to clinical tests.

Principles of treatment

Treatment of pear-shaped muscle syndrome includes drug and non-drug measures. With secondary muscle spasms, it is necessary to work on the primary disease, as much as possible to correct its manifestations.

Medicamentous therapy includes the use of NSAIDs, muscle relaxants, drugs to improve microcirculation, analgesics. With a persistent and severe pain syndrome and motor disorders, a medical blockade is indicated.

At the same time, the abdomen of spasmodic pear-shaped muscle is infiltrated with an anesthetic. Often, glucocorticosteroid preparations are used for blockades, preferably two-phase action (with a fast and prolonged component).

Their introduction allows you to reduce the severity of edema and inflammation in the muscle itself and in the sciatic nerve sheaths.

It is also possible to use compresses with dimexide, corticosteroid and anesthetic. They are imposed for 30 minutes on the gluteal-sacral region in the projection of the spasmodic muscle and the traumatized sciatic nerve passing under it.

Important components of complex therapy are also massage, physiotherapy, manual therapy using post-isometric and post-stimulative muscle relaxation, acupuncture-based reflexotherapy, vacuum and laser therapy acupuncture.

The exercises performed with the help of the exercise instructor are aimed at relaxing the pear-shaped muscle and simultaneously activating its antagonists.

Such measures supplement the action of drugs, allowing to shorten the period of treatment and avoid the use of excessively high doses of drugs with analgesic effect.

A source: https://doctor-neurologist.ru/sindrom-grushevidnoj-myshcy-simptomy-i-lechenie

Pear-shaped muscle: how to relieve spasm and inflammation, where it is located

Pain sensations in the buttocks, gradually spreading to the legs, sometimes arise after an unsuccessful injection or as a result of the development of pelvic pathologies.

One of these diseases is pear-shaped muscle syndrome (SDM). It occurs often enough, and the main problem of this disease is the complexity of diagnosis.

After all, basically the pain is unstable and manifests only in a certain position of the foot.

Despite such an uneasy task, it is necessary to reveal the spasm of the pear-shaped muscle at the appearance of the first symptoms in order to relieve compression from the sciatic nerve. In this case, the nerve pathways will quickly recover, and discomfort will soon pass.

Anatomical features

It is difficult to understand the features of this syndrome, not knowing where the pear-shaped muscle is located. You can see its location in this image:

Judging by the picture, the pear-shaped muscle has the shape of a triangle and is attached to the sacral bone.

The path of this muscle tissue passes through the sciatic hole in the tendon, which is fixed on the thigh rotor.

Pear-shaped muscle tissue serves to guide and return the hip to its original position.

Passing through the sciatic hole, the muscle tissue leaves space for the artery and sciatic nerve.

However, when the muscle is tightened or the squeezing is sharp, compression of the nerve path is possible.

In this case, we are not talking about the radicular nature of pain, since the spine is located much higher.

Signs of compression

Pear-shaped muscle syndrome has symptoms peculiar to this type of inflammation and it is possible to understand how to relieve spasm.

However, the signs of this pathology are often different, because compression can occur not only with the nerve, but also with the artery that nourishes it.

The main manifestations of inflammation of the pear-shaped muscle are as follows:

• A sign of Bonn-Bobrovnikova. This symptom is characterized by pain, which manifests itself in a certain position of the foot. Usually, to identify the presence of this symptom, the patient is put on the couch and flexes his lower limb in the pelvic region and in the knee;
• Pain sensations of aching nature. They are manifested if a person stands or walks for a long time. At this point, there is an unpleasant pulling sensation in the leg, which decreases in a lying or sitting position;
• Discomfort in the region of the ischium. The doctor can find this sign with the help of palpation. It is performed next to the sciatic nerve;
• Pelvic floor disease. If you can not remove the spasm of the pear-shaped muscle for a long time, this may indicate damage to other muscle tissues in the area;
• Sign of Vilenkin. It manifests itself in the form of painful sensations due to a tapping on the back half of the lower limb.

Sometimes the problem also concerns the sub-necked area. In this case, the following symptoms are added to the basic symptoms:

• Painful in the legs;
• The aggravation of discomfort during stress, climate change, etc .;
• Pain in the shin area after a long walk;
• Slight numbness of the skin.

Causes of development

The syndrome of the pear-shaped muscle differs from the radicular localization of the squeezing and causes of development. The similarity of these 2 diseases lies in the main factor affecting their appearance, namely, in overload. Among other reasons, the most basic ones are:

• Long stay in the cold;
• Injuries to the back;
• Pathological processes in the sacroiliac joint;
• Stenosis in the lumbar region;
• Incorrectly made injection in the gluteal region;
• Diseases of female genital organs;
• Damage to the gluteal muscles.

Diagnosis of the syndrome

It is not easy to understand that it is the pear-shaped muscle tissue that squeezes the neuromuscular bundle. Many patients describe their painful sensations as unstable. They occur mainly in certain positions of the foot or after a long walk.

Identify the syndrome of pear-shaped muscle a doctor can with the help of special manual tests, for example, palpation of muscles localized in this area.

Feeling of the damaged area allows to reveal the compaction of muscle tissues.

In some cases, novocain blockade, CT or MRI, and X-rays are used for diagnosis.

Course of therapy

The syndrome of the pear-shaped muscle is eliminated in the same way as the radicular compression and for this it is necessary to relax the muscle. If there are factors preventing this, they will have to be eliminated.

Against the background of the main part of the course of therapy the doctor will have to facilitate the general condition of the patient.

For this, symptomatic treatment is used, for example, blockade of the damaged nerve, taking analgesics, etc.

If the pear-shaped muscle is very sore, then it should be treated medically with the help of such groups of drugs as:

• Muscle relaxants;
• Spasmolytics;
• Analgesics;
• Medications that improve blood circulation;
• Non-steroidal anti-inflammatory drugs;
• Vitamins of group B.

Combine drug therapy is desirable with other techniques to relieve muscle spasm:

• Massotherapy;
• Acupuncture;
• Methods of physiotherapy;
• Physiotherapy;
• Laser puncture;
• Vacuum therapy.

With the combination of several techniques, it will be possible to accelerate the recovery of the nerve pathways, relax the muscles and alleviate the patient's condition. However, to create a set of exercises and do massage should an experienced specialist, because you can seriously damage your health.

Massage

Massaging the muscle tissue allows them to relax and improve blood circulation and nervous patency. That is why therapeutic massage is often an indispensable component of the course of therapy for spasm of pear-shaped muscle.

Begin to knead usually the circumvertebral muscles and gradually move to the lumbosacral division. Massage should be done by an experienced specialist and only after revealing the cause of the pathology, as it can aggravate its course.

The duration of the procedure usually does not exceed 20 minutes and it is advisable to visit at least 15 sessions of massage. In this case, it will be possible to achieve a visible effect and relieve tension from the pear-shaped muscle.

Exercise with SDM

With pear-shaped muscle syndrome, exercises represent the basis of therapy.

Due to them it is possible to achieve improvement of the general condition, normalization of blood circulation and removal of tension.

You can do physical exercises without leaving your home, but it is recommended that you spend a couple of sessions under the supervision of a doctor to know the correct technique for performing the movements.

Exercises to relieve spasm from the pear-shaped muscle are as follows:

• The patient should lie on the floor and bend the legs in the knee joints, and the feet are placed along the width of the shoulders. Further, the lower extremities are bred and reduced in the knees;
• Remaining in this position, it is necessary to put the feet together, after which to make the slopes knuckled together to the right and left. Perform the exercise smoothly and neatly;
• To perform this exercise you need to stand on all fours. The injured limb should be bent at the knee and set aside. Then this leg should be slowly straightened and returned to its original position. The same action is also performed on another limb;
• Sitting on a chair, you need to straighten your back and put your feet evenly. Next, you should put a sick limb on a healthy knee and reach for it with the whole body. Back then, you should try not to hump and after doing the slope change your leg.

Doing exercises to relax the pear-shaped muscle, you must exactly follow the correct technique of execution. Find out about all of its nuances preferably from your doctor.

With a pear-shaped muscle syndrome, a person experiences severe discomfort. However, sometimes the pain is unstable, so many people go to see a doctor.

In this case, it will be possible to avoid problems and recovery will be much faster.

A source: http://NashiMyshcy.ru/omyshcax/sindrom-grushevidnoj-myshcy-uprazhneniya-dlya-rasslableniya.html