What Is Piriformis Syndrome?
The piriformis is a small, pear-shaped muscle buried deep in the buttock. It attaches from the sacrum at the base of the spine to the top of the thigh bone. Its job is to rotate and stabilise the hip, particularly during walking, standing, and changing direction.
The sciatic nerve, which runs from the lower back down the leg, passes very close to (and in some people, directly through) the piriformis. When the muscle becomes tight, overactive, or irritated, it can compress or irritate the sciatic nerve, producing symptoms that mimic sciatica.
What Are the Symptoms?
Piriformis syndrome tends to present with symptoms that develop gradually over weeks, progressively worsening. Commonly reported symptoms include:
- Deep aching or burning in the buttock
- Pain that worsens with sitting, climbing stairs, or driving
- Occasional shooting pain down the back of the thigh
- Pins and needles or numbness down the leg
- Tenderness when pressing into the buttock
What Causes It?
Piriformis syndrome usually develops due to a combination of factors. For some people, they may notice symptoms after spending prolonged amounts of time sitting on hard surfaces or after a sudden increase in activities such as hiking or running.
Predisposing factors include weakness in the surrounding gluteal muscles, forcing the piriformis muscle to activate more than usual.
Stiffness in the hip joint can also lead to increased tension through the muscle and altered biomechanics when moving.
Poor sleep positions or asymmetrical daily postures can also contribute to the development of piriformis syndrome.
How Can Physiotherapy Help?
Your physio will perform an assessment to determine an accurate diagnosis and identify factors contributing to the condition, including lifestyle factors, tight and/or weak muscles, and stiff joints.
A clear treatment plan will be developed to address biomechanical issues, including gluteal strengthening to reduce the load on the muscle.
Where sciatic nerve irritation is present, specific nerve mobility work may be included, along with manual therapy and soft tissue release for short-term pain relief while strength is being built.
They will recommend changes to daily habits contributing to the condition, help plan daily movement adjustments, and provide an ergonomic assessment of your home and/or work setup.
None of the information in this newsletter is a replacement for proper medical advice. Always see a
medical professional for advice on your individual injury.