October 5, 2023

Piriformis Syndrome – Causes, Symptoms, Diagnosis, and Management

The compression of the sciatic nerve by the piriformis muscle can result in piriformis syndrome, a neuromuscular disorder. This condition is quite rare. The piriformis muscle is located around the top of the hip joint in the buttocks. This muscle has a flat, band-like look. It maintains the hip joint while also elevating and rotating the thigh away from the body. Consequently, it is essential for the lower body’s movement.

Symptoms and signs of piriformis syndrome

Patients frequently report acute buttock discomfort and sciatic-like pain that radiates down the back of the leg, calf, and foot. Examples of typical piriformis syndrome symptoms include:

A persistent ache in the buttock region

The backs of one’s thighs, calves, and feet are throbbing with pain (sciatica)

Experiencing discomfort while ascending stairs or slopes

A worsening of pain after sitting for extended durations

Mobility of the hip joint with a restricted range of motion

What causes piriformis syndrome, and what risk factors contribute to its development?

If there is pressure on or compression of the piriformis muscle in some areas of the sciatic nerve, it can lead to this condition. The following sports-related injuries are examples of risk factors that may contribute to piriformis syndrome:

The inflammatory reaction (any cause such as muscle overuse due to sports, sprain)

Trauma (usually blunt trauma to the buttocks)


Development of a scar

People who experience any of the symptoms listed in or around the piriformis muscles are also at risk for developing piriformis syndrome:




Diagnosing piriformis syndrome

Make an appointment with your health care physician if the discomfort or numbness in your buttocks or legs persists for more than a few weeks. Depending on the underlying cause, symptoms of sciatica might last weeks or months. If your signs and symptoms constantly change, you must visit your primary care doctor to check if it is piriformis syndrome for proper treatment.

During your session, the doctor will review your overall case history, symptoms, and potential causes. Be prepared to provide detailed information about your symptoms when discussing them. Inform your physician if you have recently experienced an accident, such as tripping and falling, or if you strained a muscle while playing sports. Do not worry if you are unsure whether this was the origin of your symptoms.

In addition, your physician will conduct a health examination where you might be expected to do various actions to establish which movements are painful. There is a possibility that additional imaging tests will be necessary to help rule out other potential causes of your pain. With an MRI or CT scan, your physician may be able to identify whether arthritis or a ruptured disc is the cause of your symptoms. If piriformis syndrome appears to be the underlying source of a patient’s symptoms, an ultrasound of the piriformis muscle might aid in reaching a diagnosis.

Potential therapies for piriformis syndrome

Ice packs or massages using ice

If you experience discomfort in your buttocks or sciatica, you should immediately apply ice to the affected area. If you notice that particular activities exacerbate your pain, using ice on the affected area immediately after the training can be of assistance. Use this therapy as necessary every two to four hours. Ice massages are pretty advantageous and should be conducted whenever possible. While on your stomach, have someone massage the affected area with a large ice cube. Limit the massage to 10 minutes to avoid experiencing an ice burn.

Injections administered for the piriformis

In certain instances, your doctor may decide to provide an injection directly into the piriformis muscle. In severe cases, your physician may consider Botox injections to relax the muscle and relieve strain on the sciatic nerve. Both injections are intended to offer sufficient pain relief to allow you to expand the piriformis muscle and engage in physical therapy. This will ensure that the muscle remains stretched and relaxed long after the effects of the injection have worn off.

Physiotherapy and stretching

Progressively stretching the piriformis muscle is the most effective treatment for piriformis syndrome. Your primary care physician may instruct you to practice basic stretches to relax the piriformis, hamstring, and hip muscles, increase flexibility, and restore range of motion. These also stretches aid in muscle recovery. In addition, a complete physical therapy program for piriformis syndrome includes range-of-motion exercises and deep tissue massages that can help minimize muscular spasms and enhance blood flow to the affected area, both of which are essential for the patient’s continued healing.

Therapeutic heat application

People may find relief from discomfort by alternating between heat and cold. One of the effective treatments for piriformis syndrome can be to try resting on your stomach with a heating pad placed on the affected area for up to twenty minutes.

Take a hot bath to relax, and then stretch

After soaking in a warm bath, carefully stretch your muscles. If you experience lower leg pain, try sitting or standing with your toes pointed and straightened. If you are having pain in the upper region of your leg, you should strive to touch your toes while bending over.

Is it possible to avoid developing piriformis syndrome?
It is conceivable that once your symptoms have improved, you will need to modify your activities to decrease the risk of recurrence. With the use of the following preventative actions, piriformis syndrome can be avoided:

Regular exercise is essential, but you should always stretch beforehand.

Always maintain a straight back and shoulders when standing, sitting, or driving.

Don’t lift by bending over. Squatting and bending your knees will make it easier for you to take up an object. Maintain an upright position while bringing the thing near to your body. Avoid twisting your body in any manner during lifting.

It is preferable to avoid sitting or lying down in a position that exerts significant strain on the buttocks for extended periods.

Managing the symptoms of piriformis syndrome

Piriformis syndrome may arise and disappear at different times depending on your activity level. Please make an effort to determine the behaviors that appear to be causing it. By executing the necessary exercises, you may guarantee that you stretch the piriformis muscles before and after partaking in these activities.


Piriformis syndrome is an uncommon condition that can be difficult to diagnose because of its rarity. In most instances, the condition is treatable with rest and physical treatment. Your lower back and legs will feel better before, during, and after your workout if you keep active and stretch before engaging in physical activity.