What is piriformis syndrome?

Piriformis syndrome is a medical condition that causes pain and spasms in the buttocks. Often, the piriformis muscle aggravates or constricts the sciatic nerve and causes tingling, numbness and pain down the back of the leg to the foot.

Causes of piriformis syndrome

Piriformis syndrome is caused when the sciatic nerve is compressed when it goes through the buttock. Other causes of piriformis syndrome include:
  • Trauma or injury — trauma or injury to the buttock area that leads to compression of the sciatic nerve.
  • Overuse — overuse from activities like running, walking, rowing, cycling, downhill skiing can lead to inflammation in the piriformis muscle and as a result irritation of the sciatica.

Risk factors for piriformis syndrome

  • Gender — females develop piriformis syndrome six times more often than men due to anatomical differences.
  • Sedentary lifestyle — people who sit most of the day for careers or lifestyle are at a higher risk of developing piriformis syndrome.

Symptoms of piriformis syndrome

The most common symptoms of piriformis syndrome are dull aches or tenderness in the buttock and pain that radiates down the back of the leg and into the foot.
Other symptoms include:
  • Tingling along the back of the leg and into the foot
  • Pain when walking up stairs or after sitting for a long period of time
  • Reduced motion in the hip

Diagnosis of piriformis syndrome

Diagnosing piriformis syndrome is challenging. There are not any diagnostic tests to confirm the diagnosis. Your doctor will take a full medical history and perform a full physical exam to determine what conditions can be ruled out.

Your physician will take your medical history, including reviewing your symptoms, determining what activities or positions make the condition more painful and inquire how long the symptoms have been present.

In the physical exam, the physician will determine what motion causes the symptoms to worsen.

Treatment for piriformis syndrome

The goal of treating piriformis syndrome is to alleviate the pain and progressively stretch the piriformis muscle. In some cases, home therapy with rest, ice, heat and anti-inflammatory medications will relieve the pain associated with piriformis syndrome.

Physical therapy and rehabilitation
There are several stretches that can strengthen and stretch the muscle to alleviate the pain. In more severe cases, your physician will prescribe physical therapy and rehabilitation.

Your physical therapist will work with you to develop a treatment plan that will get you back to normal activities as quickly as possible. He or she may customize range of motion exercises especially for you or perform deep massage to the affected area.

Newer therapies for piriformis syndrome are transcutaneous electrical nerve stimulation (TENS) or interferential current stimulator (IFC). These therapies use electrical stimulation on the impacted area. The electrical waves can reduce muscle spasms and therefore alleviate pain.

Recovery from piriformis syndrome

Piriformis syndrome is often misdiagnosed, so recovery is delayed. If caught quickly and treatment is started right away, patients can eliminate the pain in days or weeks.

Patients who delay treatment may develop chronic piriformis syndrome, which is very challenging to treat.

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