3 Common Causes of Piriformis Syndrome

Piriformis Syndrome is a painful condition caused when the piriformis muscle compresses the sciatic nerve causing pain, numbness, and tingling along the back of the leg and into the foot. The piriformis muscle is a flat, band-like muscle located in the buttocks near the top of the hip joint. This muscle is important in lower body movement because it stabilizes the hip joint and lifts and rotates the thigh away from the body. Therefore, it is used in almost every motion of the hips and legs.


Most patients describe symptoms as acute tenderness in the buttock and sciatica-like pain down the back of the thigh, calf, and foot. Typical piriformis syndrome symptoms may also include:

  • A dull ache in the buttock
  • Pain and/or paresthesia (pins and needles, numbness, burning, tingling, or itching sensations radiating down the back of the thigh, calf, and foot (sciatica)
  • Pain when walking upstairs or inclines
  • Reduced range of motion of the hip joint
  • Difficulty with walking and other functional activities, such as pain with sitting, squatting and standing.

These symptoms often worsen after prolonged sitting, walking, or running and may feel better after lying down on the back.

Causes of Piriformis Syndrome

The exact causes of Piriformis Syndrome are unknown. Suspected causes include:

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

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

Diagnosing Piriformis Syndrome

Diagnosis of piriformis syndrome is based on a review of the patient’s medical history, a physical examination, and possibly diagnostic tests.

Diagnostic tests (such as X-rays, MRI, and nerve conduction tests) may not be able to diagnose Piriformis Syndrome precisely. Still, they can be conducted to exclude other conditions that can cause similar symptoms to piriformis syndrome.

Piriformis Syndrome Treatment

Depending upon each case, there will be different treatment plans based on the severity of each patient.

When the symptoms are relatively mild, a person can try the following home remedies:

  • Using ice or heat packs
  • Massaging the entire hip and buttock area
  • Taking over-the-counter non-steroidal anti-inflammatory drugs. 
  • Avoiding activities that make the pain worse, like exercise, playing sports, and a lot of walking, 
  • Resting after an injury

In cases where medical treatment is needed to help relieve severe pain from piriformis syndrome. These may include:

  • Botox injections can reduce muscle spasms and relieve pain.
  • Prescription pain medications or muscle relaxants. 
  • Corticosteroid or anesthetic injections.
  • Acupuncture and trigger point therapy.
  • Physical therapy to regain use of the piriformis and prevent atrophy related to disuse and dysfunction in surrounding muscles.
  • Osteopathic manipulative treatment is used to help relieve pain and increase the range of motion.
  • As a last resort, a person may consider surgery to cut the piriformis tendon where it attaches to the hip or to cut into the piriformis to relieve pressure on the sciatic nerve.

It is not a very common condition, but it is essential to visit a professional to get a proper diagnosis to improve your life and find the best way to relieve your pain. Here at Spine Health and Wellness, we can provide a long-term solution!

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