What is piriformis syndrome, and how can you treat it?

Got a pain in the buttocks? It could be piriformis syndrome, says Nick Beer. Here he explains causes, symptoms and treatment

What is piriformis syndrome

The small piriformis muscle sits behind the glutes in your buttocks, and plays a vital role when we walk. It enables the leg to rotate outwards from the hip, and provides stability to the sacrum and sacroiliac joints.


Often described as a ‘pain in the buttocks’, piriformis syndrome is a tightening and irritation of this muscle, which can cause pain, numbness and tingling down the leg. The sciatic nerve runs in very close proximity to the piriformis muscle, and when the muscle becomes tight or inflamed, it can compress and irritate the nerve.

The most common cause of piriformis syndrome is the muscle being overworked. Poor biomechanics – a possible result of over-pronating feet and weaknesses in the deep hip-stabilising muscles – can place unnecessary stress on the piriformis muscle and its surrounding structures.

To treat piriformis syndrome effectively, it’s important to initially manage the pain. Massage and electrotherapy are two treatments that can increase blood flow to the soft tissues. The next step is to gradually introduce joint-mobilisation techniques to restore range of movement. Then start to employ deep core stability and hip-strengthening exercises to steady the pelvis. A thorough biomechanical assessment could also be beneficial for long-term success.

Piriformis syndrome is often confused with sciatica, which is a pain in the nerve resulting from a lower-back disc bulge. These are two different diagnoses, but can elicit similar symptoms. It’s important to differentiate early on, as the rehabilitation strategies are quite different.

If you are concerned about an injury, or any worrying symptoms, please seek medical advice from a doctor or another medical professional


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