What is Piriformis Syndrome?

Piriformis Syndrome is a condition in which the piriformis muscle, a small muscle located deep in the buttock (behind the gluteus maximus), irritates the sciatic nerve. It is a common disorder, particularly among people who are over 40 years old, with over 200,000 cases per year in the United States.

What are the Causes?

Although the exact causes of piriformis syndrome are unknown, several suspected causes have been identified, including:

  • Muscle spasm in the piriformis muscle, either because of irritation in the piriformis muscle itself, or irritation of a nearby structure such as the sacroiliac joint or hip
  • Tightening of the muscle, in response to injury or spasm
  • Swelling of the piriformis muscle, due to injury or spasm
  • Bleeding in the area of the piriformis muscle.

Any one or combination of the above problems can affect the piriformis muscle (causing buttock pain) and may affect the adjacent sciatic nerve (causing pain, tingling, or numbness in the back of the thigh, calf, or foot).

What are the Symptoms?

Typical symptoms include acute tenderness, tingling or numbness in the buttocks and sciatica-like pain down the back of the thigh, calf and foot. Symptoms may become worse after prolonged sitting, climbing stairs, walking, or running, and lying down on the back may offer relief.

Additional piriformis syndrome symptoms may include:

  • A dull ache in the buttock
  • Pain down the back of the thigh, calf and foot (sciatica)
  • Pain when walking up stairs or inclines
  • Increased pain after prolonged sitting
  • Reduced range of motion of the hip joint

What are the Treatments?

Typically, treatment initially consists of a physical therapy program consisting of stretching exercises for the piriformis muscle, massage, range of motion exercises, anti-inflammatory drugs, or surgery.

  • Non-Surgical treatments include:
  • Ice Packs and Ice Massage
  • Heat Therapy
  • Anti-inflammatory medications such as Ibuprofen or naproxen
  • Piriformis Injection
  • Botox Injection
  • Electrotherapy for Piriformis Syndrome
  • Therapeutic ultrasound