Piriformis Syndrome


One common cause of pain down the leg or leg pain is Piriformis syndrome. Piriformis syndrome is named after the piriformis muscle. The piriformis muscle is located in the lower part of the spine (sacrum), connects to the thighbone (femur), and assists in hip rotation. The sciatic nerve runs beneath the piriformis muscle. This muscle is susceptible to injury from a slip and fall, hip arthritis, or a difference in leg length. Such situations can cause cramping and spasm to develop in the piriformis muscle, thereby pinching the sciatic nerve – causing inflammation and pain.

Muscle spasms and/or contraction of the piriformis muscle itself can lead to pain along the back of the thigh, down to the knee, causing a possible loss of sensation or numbness and tingling in the sole of the foot. The piriformis syndrome can often mimic the well known complaint known as sciatica.  Because of the similar symptoms, it is often misdiagnosed as sciatica. The main difference between sciatica and piriformis syndrome is the cause. What both of these complaints have in common is that both can produce pain, and/or numbness and tingling below the knee and into the foot.

This has been the ‘special of the week’  in my practice.  It can be left or right, depending on the activity that can irritate the area.

Who Does This Affect?

Many athletes are prone to piriformis syndrome.  The athlete’s cause is primarily due to improper stretching and warm-up exercises as well as overuse during activity. In this case it is most likely that the piriformis muscle is irritated and usually in spasm.

People who spend long hours sitting are prone to this syndrome.  It can be from sitting at a desk, in front of a computer, students, riding in a car or truck for long periods of time, and sitting on a wallet.

People who sit for extended periods of time, especially with poor posture are prone to the piriformis being irritated.

What Causes Piriformis Syndrome?

The primary cause is due to tightness and contracture of the piriformis muscle. In this case the piriformis muscle is shortened and does not allow for the smooth movement of the sciatic nerve during leg motion.
The causes of piriformis myospasm are varied such as overuse, excessive fast walking without proper warm up and stretching, prolonged sitting.

Treatment for Piriformis Syndrome

As for treatment of piriformis syndrome, many variables can hinder your successful recovery:  including but not limited to smoking, obesity, job limitations and improper exercise (not warming up and stretching).  It is very rare to have a piriformis syndrome from a one-off direct trauma to the area.

Any treatment plan must include stretching of the gluteal muscles as well as stretching of the piriformis muscles.

Chiropractors can assist you by recommending the proper exercises and stretches to perform. Many Chiropractors may also suggest some form of muscle therapy to the piriformis muscle in the gluteal region in order to assist in relaxing these muscles.

Relevant adjustments to the spine, pelvis, sacrum as well as hip may be required to relieve the pressure from the nerve being trapped from the piriformis muscle.

9 thoughts on “Piriformis Syndrome

  1. Karmen Elsbury

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  2. chiropam Post author

    Thank you Karmen for your comment. Look forward to sharing information with you in the future.

  3. Lynda Matthews

    My husband started complaining of sore thigh muscles – right leg – back toward end of 2009. By March of 2010 he commented his right hip was paining. Within a week he needed to use a cane to give support and take pressure off the right leg. We were in the middle of a move; and he had become incapacitated so quickly that he started using a walker to take pressure off the leg and hopefully correct the way he was walking – i.e. hip was now throwing. At present he cannot sit comfortably for severe aching in the centre of right buttock; painful hip and sore right thigh. Does this sound like it could possibly be piraformis entrapment of some sort? When he walks with the walker – he is leaning over (he says only way he can get comfortable) -and his back is slanted to the left – i.e. left shoulder high; and back slanted toward the right hip.

  4. chiropam Post author

    @Lynda – It is very possible that the sciatic nerve symptoms are involved with the piriformis muscle. I would strongly suggest you seek an experienced, recommended chiropractor in your area for a professional opinion. Good luck!

  5. Phillip Meadows

    I think I suffer from piriformis-syndrome but my insurance will not cover it. they exclude any pre-existing condition like sciatica or back injuries, it do not mention piriformis-syndrome by name. What can I do? I can not afford to pay out of pocket.

  6. chiropam Post author

    Hi Phil,

    No piriformis syndrome and sciatica are not the same thing. Sciatica is a general term for radiating pain down the leg with different possible causes of the ‘dysfunction’. Piriformis Syndrome is one of the causes of sciatica pain.
    Have you read the post on Sciatica that I wrote?

  7. chiropam Post author

    I would suggest you do some research in your area for a chiropractor that does not work strictly with insurance, but more of a private structure so that it may be more affordable to you.

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