Piriformis Syndrome

Piriformis syndrome is a common condition where the piriformis muscle, located in the buttocks region, becomes tight or irritated, leading to pain and discomfort. This condition can affect people of all ages and activity levels, causing difficulty with sitting, walking, or engaging in physical activities.

Physical therapy treatments such as stretching exercises, hot and cold therapy, and massage can help provide relief.

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Causes of Piriformis Syndrome

Piriformis syndrome typically develops due to irritation or compression of the sciatic nerve as it passes through or underneath the piriformis muscle. Some common causes and risk factors include:

  • Muscle Tightness or Spasm: Tightness or spasms of the piriformis muscle can compress the nearby sciatic nerve, leading to pain and discomfort in the buttocks and down the back of the leg.
  • Overuse or Repetitive Movements: Activities that involve repetitive movements of the hip or prolonged sitting can irritate the piriformis muscle.
  • Trauma or Injury: Direct trauma to the buttocks region, such as a fall or impact injury, can injure the piriformis muscle and lead to inflammation or irritation of the sciatic nerve.
  • Anatomical Variation: Some individuals may have variations in the anatomy of the piriformis muscle or sciatic nerve that predispose them to piriformis syndrome.

Symptoms of Piriformis Syndrome

Piriformis syndrome can cause a range of symptoms that may vary in severity and duration. Common symptoms include:

  • Pain in the Buttocks: The most common symptom of piriformis syndrome is pain in the buttocks region, which may be dull, achy, or sharp.
  • Radiating Pain: Pain may radiate from the buttocks down the back of the leg, following the path of the sciatic nerve. This pain may worsen with sitting, walking, or certain movements.
  • Numbness or Tingling: Some individuals may experience numbness, tingling, or a pins-and-needles sensation in the buttocks, thigh, or leg affected by piriformis syndrome.
  • Difficulty Sitting or Walking: Pain and discomfort from piriformis syndrome can make it difficult to sit for prolonged periods or engage in activities that involve hip movements, such as walking or climbing stairs.


Diagnosing piriformis syndrome typically involves a thorough medical history and physical examination and may include imaging studies or diagnostic tests to rule out other conditions.

Medical History

Your healthcare provider will ask about your symptoms, medical history, and any previous injuries or activities that may contribute to piriformis syndrome.

Physical Examination

A physical examination may be performed to assess muscle strength, range of motion, and tenderness in the buttocks and hip region. Your provider may also perform specific maneuvers to reproduce symptoms associated with piriformis syndrome.

Imaging Studies

While there are no specific imaging tests to diagnose piriformis syndrome, imaging studies such as MRI or ultrasound may be ordered to rule out other potential causes of symptoms, such as herniated discs or structural abnormalities.

Diagnostic Injections

In some cases, diagnostic injections such as piriformis muscle injections or nerve blocks may be used to help confirm the diagnosis by temporarily relieving pain associated with piriformis syndrome.

Treatments for Piriformis Syndrome

Treatment for piriformis syndrome aims to alleviate pain, reduce inflammation, and improve mobility and function.

Rest and Activity Modification

Resting the affected area and avoiding activities that exacerbate symptoms can help reduce pain and inflammation associated with piriformis syndrome. Modifying activities to avoid prolonged sitting or repetitive hip movements may also be beneficial.

Stretching and Strengthening Exercises

Physical therapy exercises that target the piriformis muscle, as well as other muscles of the hip and pelvis, can help improve flexibility, strength, and mobility, reducing pressure on the sciatic nerve.

Manual Therapy

Techniques such as massage, myofascial release, or manual stretching performed by a qualified healthcare provider can help relax tight muscles, reduce muscle spasms, and improve blood flow to the affected area.

Heat or Cold Therapy

Applying heat or cold packs to the affected area can help reduce pain, inflammation, and muscle tension associated with piriformis syndrome. Alternating between heat and cold therapy may provide additional relief.


Over-the-counter pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to help manage pain and reduce inflammation associated with piriformis syndrome. In some cases, muscle relaxants or nerve pain medications may be prescribed.

Injection Therapies

Corticosteroid injections or trigger point injections into the piriformis muscle or surrounding tissues may provide temporary pain relief and reduce inflammation in some individuals with piriformis syndrome.

Lifestyle Modifications

Making lifestyle changes such as improving posture, practicing good body mechanics, and incorporating regular exercise and stretching into your routine can help prevent the recurrence of piriformis syndrome and promote long-term musculoskeletal health.


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