Is Piriformis Syndrome
Causing Your Leg Pain?

If you are experiencing sciatica symptoms, you could have Piriformis Syndrome. What is this condition? If you have it, what are the treatment options?




What is Piriformis Syndrome?

The piriformis muscle is a small muscle that attaches from the Sacrum to the greater trochanter of the femur. This small muscle acts as an external rotator of the hip.

The sciatic nerve is formed by the lumbar 4 through sacral 3 nerve roots. This nerve helps to supply both sensation and muscle control to the leg. The piriformis muscle is located right above the sciatic nerve as it exits the sciatic notch. Piriformis syndrome, often diagnosed as sciatica , occurs when the piriformis muscle becomes tight, pressing on the sciatic nerve and resulting in nerve related symptoms radiating down the leg.


piriformis syndrome


Typical Symptoms

Symptoms related to this syndrome include pain, numbness, or tingling down the back of the leg. At times these nerve related symptoms can be dull and constant and at other times be sharp. A feeling of tightness or a deep ache in the buttocks region is also common. In significant cases, weakness in the leg can also occur.
Because of the position of the piriformis muscle, symptoms are generally reproduced in positions of sitting when the knee is higher than the hip. For this reason, sitting in a car with bucket seats can be specifically aggravating.

piriformis sitting posture


In addition, symptoms can be aggravated when the piriformis is in a stretched position such as with walking up hill or up stairs.

The leg nerve pain related to this condition is often confused with other spine conditions. Because the origin of pain is at the level of the piriformis muscle, lower back pain is not a symptom. If you are experiencing back pain, it is not likely that the piriformis is the cause of the symptoms. Other conditions that can mimic similar pain patters include spinal stenosis, degenerative disc disease, or a herniated disc. Because these spinal conditions are far more common, it is important that you obtain a thorough examination and diagnosis to determine the true cause of your leg symptoms.



Typical Treatment

Treatment for piriformis syndrome includes reducing inflammation, improving piriformis flexibility, and minimizing aggravating positions or activities.

As with many conditions, the use of ice therapy is an effective tool for reducing inflammation. The piriformis muscle itself can become inflamed, leading to tightness and increased pressure on the sciatic nerve. Apply ice directly to the buttocks region, 10 minutes at a time, frequently throughout the day. Of course the use of anti-inflammatory medication can also be helpful in reducing local soft tissue inflammation (consult your doctor regarding medications).

Another key component is to minimize aggravating activities. Minimize walking up hill and up stairs. Avoid activities such as riding a recumbent stationary bike as this position puts the piriformis muscle on stretch. As sitting with your knees higher than your hips is an aggravator, the use of a seat wedge can be helpful in avoiding this position.


seat  wedge


Physical Therapy

Physical therapy is very helpful in treating this condition. The use of ultrasound and manual cross friction massage to the piriformis muscle is very effective in increasing soft tissue mobility. In addition, doing self massage using a tennis or racquetball can also be performed to decrease piriformis tightness.


piriformis massage


Self stretching to increase piriformis flexibility is also part of an effective treatment program. To stretch the piriformis while lying on your back, place the outer foot of the leg you are stretching on the knee of the opposite leg. Grab behind the thigh and pull this knee up toward your chest. The stretch should be felt in your buttock. Hold for 30 seconds and repeat 3 times, a few times a day.


piriformis stretch


The piriformis muscle can also be stretched in sitting. To do so, cross the leg to be stretched by placing the outer aspect of the foot on the knee of the opposite knee. Keeping your lower back straight, lean forward until a stretch is felt in the buttocks. Hold for 30 seconds and repeat 3 times, a few times a day.


sitting piriformis stretch


Piriformis syndrome can often be confused with other lower back conditions. If you are experiencing this nerve related condition, follow the simple treatment recommendations to help alleviate your leg pain.




Return to Top

Return from Piriformis Syndrome to Lower Back Pain Home