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Piriformis Syndrome

The effects of piriformis syndrome can range from an annoying pain in the butt to a real sidelining injury.

Piriformis syndrome is characterized by pain and tightness in the lower back/gluteal region and can oftentimes radiate down the leg. Numbness, tingling or a burning sensation can also occur, and when severe, weakness in the leg may also be present.


Sound similar to sciatica? Well, it kind of is…


The piriformis muscle lies deep beneath the gluteal muscles and acts to rotate the hip and stabilize the pelvis. Running directly underneath the piriformis muscle is the largest and longest nerve in the human body: the sciatic nerve.

Some of the most common causes of piriformis syndrome include long-distance running or cycling, sitting for prolonged periods of time, or blunt trauma. Inflammation and/or dysfunction in the joints of the pelvis or hip are often known to irritate the piriformis muscle as well (1).

A tight, inflamed, or piriformis muscle in spasm can be a painful situation as it is, but it also has the potential to compress and irritate the sciatic nerve traveling right beneath it.

The term “sciatica” is used to describe pain that originates from sciatic nerve irritation, and is typically felt in the gluteal region and radiates down the back of the leg. However, true sciatica is most commonly due to spinal issues like disc herniations, degenerative disc disease, or lumbar spinal stenosis.


Piriformis syndrome is often misdiagnosed because of its similar presentation to sciatica. Furthermore, it is possible to have both piriformis syndrome and sciatica at the same time.  A proper exam and history are necessary to determine the diagnosis.


Some of the most common causes of piriformis syndrome include long-distance running or cycling, sitting for prolonged periods of time, or blunt trauma. Inflammation and/or dysfunction in the joints of the pelvis or hip are often known to irritate the piriformis muscle as well (1).


Research has shown that conservative treatment for piriformis syndrome- such as strengthening exercises, chiropractic, and soft tissue manipulation - can significantly improve a vast majority of cases (2,3).  Active Release Technique (ART ™) is a unique, movement-based, soft tissue technique that benefits a wide array of musculoskeletal conditions- including piriformis syndrome.


So don’t let the pain in your backside get the best of you. Our Doctors of Chiropractic perform a thorough exam and utilize a variety of therapeutic approaches, like ART™, to help keep your body feeling and functioning at its best. Give us a call to schedule an appointment today.


1.) Brukner & Khan, Clinical Sports Medicine. 3rd Ed. 2007. Mcgraw Hill.

2.) Fishman, L.M., Dombi, G.W., Michaelsen, C., Ringel, S., Rozbruch, J., Rosner, B., & Weber, C. (date). Piriformis syndrome: Diagnosis, treatment, and outcome- a 10-year study. Archives of Physical Medicine and Rehabilitation, 83(3), 295-301.

3.) Gulledge, B.M. (2014). Comparison of two stretching methods and optimization of stretching protocol for the piriformis syndrome. Medical Engineering and Physics, 36, 212-218.


Originally posted on January 21, 2019

Original author: Marlee VanWinkle, DC

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