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Piriformis Syndrome

Piriformis Syndrome occurs when the sciatic nerve is irritated, pinched, entrapped, or compressed. Entrapment and irritation of the sciatic nerve can cause muscle spasms and tightness in the buttocks area, which can then refer pain down the back of the thigh and leg.

Piriformis Syndrome Symptoms Include:

  • Acute tenderness in the buttocks and down the back of the leg

  • A dull ache in the mid-rear, radiating down the back of the leg

  • Numbness and tingling in the buttocks and down the back of the leg

  • Pain may be worse after prolonged sitting or putting pressure on the buttocks

The piriformis muscle is located in the buttocks near the top of the hip joints and plays a critical role in the movement of the hips and legs. The sciatic nerve passes underneath the piriformis muscle and over other external hip rotators; hence any tightness or irritation of the piriformis muscle can compress, pinch, or irritate the sciatic nerve, leading to pain in the back and/or buttocks which radiates down the leg and even the foot (sciatica).

Causes of Piriformis Syndrome

Prolonged sitting is among the most common Piriformis Syndrome causes.

Prolonged sitting is among the most common Piriformis Syndrome causes.

Piriformis Syndrome can result from overuse of the lower extremities, such as in prolonged sitting or long distance running. Overuse of the piriformis muscle can also be a result of weakness in the gluteal muscles, which stabilize the hip. Tight adductor muscles may also increase strain on the piriformis. Since the piriformis muscle assists in abducting and laterally rotating the thigh, reduced range of motion and tightness of the hip joint is another symptom of this condition.

Piriformis Syndrome is often worse following prolonged sitting, stair climbing, or squatting; people with the condition find relief from lying down on their backs and stretching the hip joint, which helps release pressure of the muscle on the nerves.

Try These Simple Piriformis Syndrome Exercises

Lie on your back and flex your right hip and knee while grasping the right knee with your left hand; pull the knee towards your left shoulder. Now grab just above the right ankle with your right hand and rotate the ankle outwards.

This same exercise can also be performed while sitting at your desk: Sitting tall, feet on the floor, take the affected side and place the leg onto the opposite knee so you have now created the four.  Use your hands on your ankle to keep your leg in place on the opposite thigh.  Use your elbow of the same affected leg to put pressure down on the inside of the knee to create tissue tension.  Hold the stretch for as long as you can to open up the external hip rotators and alleviate pressure on the sciatic nerve.

Note: Before diagnosing Piriformis Syndrome, it is often necessary to first rule out other low-back conditions (such as lumbar disc herniation or sacroiliac joint syndrome) which have similar symptoms.